Data on Opioids in the Workplace

tablet and charts on a table

  • Drug overdose deaths have increased between 2020 and 2021 in the United States.
    • The age-adjusted rate of drug overdose deaths rose more than 14%.
    • Drug overdose death rates increased for all age groups 25 and over. Adults aged 65 and over had the largest percentage increase.
    • The rate of drug overdose deaths increased for deaths involving cocaine and those involving psychostimulants with abuse potential.
  • In 2021, 106,699 drug overdose deaths occurred, resulting in an age-adjusted rate of 32.4 per 100,000 standard population in the United States. That is more than any other year on record.
  • Overdose deaths involving synthetic opioids other than methadone (largely illicitly manufactured fentanyl) accounted for nearly 22% of those deaths, almost doubling since 2019.
  • In 2021, an estimated 3% of survey respondents 18 years or older reported misusing opioids. An estimated 51% of these respondents had full- or part-time jobs.
  • A survey from the National Safety Council found that 75% of employers report that opioid use has impacted their workplace. However, only 17% report being extremely well-prepared to address the issue.5

Workers’ Compensation Data

In 2005, Franklin et al. published a study that identified an unusual increase in unintentional opioid-involved overdose deaths. It also determined that these deaths occurred among workers who received opioid prescriptions for non-catastrophic injuries, such as carpal tunnel syndrome or low back pain. Over half of these workers received prescriptions for a schedule II opioid.10, 11 These findings contributed to the development of the first US opioid prescribing guidelines.10, 11, 12 Since that time, states have made substantial progress in limiting opioids in workers’ compensation systems, but efforts continue. Below is a summary of key study findings.

1 – Mattson, C.L., Tanz, L.J., Quinn, K., Kariisa, M., Patel, P., Davis, N.L. (2021). Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013–2019. MMWR Morb Mortal Wkly Rep 2021; 70:202–207.

2 – Ahmad, F.B., Rossen, L.M., Sutton, P. (2021). Provisional Drug Overdose Death Counts. National Center for Health Statistics. Designed by L.M. Rossen, A. Lipphardt, F.B. Ahmad, J.M. Keralis, and Y. Chong: National Center for Health Statistics.

3 – Kariisa M, Davis NL, Kumar S, et al. Vital Signs: Drug Overdose Deaths, by Selected Sociodemographic and Social Determinants of Health Characteristics — 25 States and the District of Columbia, 2019–2020. MMWR Morb Mortal Wkly Rep. ePub: 19 July 2022. DOI:

4 – Substance Abuse and Mental Health Services Administration: Center for Behavioral Health Statistics and Quality. (2020). Results from the 2020 National Survey on Drug Use and Health: Detailed tables, Table 1.61 A,B. 2019—2020.

5 – National Safety Council. (2019). National Employer Survey 2019. Poll: 75% of Employers Say Their Workplace Impacted by Opioid Use.

6 – Bureau of Labor Statistics.  (2021).  Economic News Release: Census of Fatal Occupational Injuries Summary, 2020.  Washington, DC:  Bureau of Labor Statistics, Update, December 16, 2021. 

7 – Tiesman, H.M., Konda, S., Cimineri, L., et al. (2019). Drug overdose deaths at work, 2011–2016 Injury Prevention 2019; 25:577-580.

8 – Massachusetts Department of Public Health: Occupational Health Surveillance Program. (2019). Fatal Injuries at Work: Massachusetts Fatality Update, 2016-2017.

9 – Goplerud E., Hodge S., & Benham T. (2017). A Substance Use Cost Calculator for US Employers With an Emphasis on Prescription Pain Medication Misuse. Journal of Occupational and Environmental Medicine, 59(11), 1063–1071.

10 – Quinones, S. (2015). Dreamland: The True Tale of America’s Opiate Epidemic. Bloomsbury Press. Pgs 202-205, 232-235, 310.

11– Franklin, G. M., Mai, J., Wickizer, T., Turner, J. A., Fulton-Kehoe, D., & Grant, L. (2005). Opioid dosing trends and mortality in Washington State workers’ compensation, 1996-2002. American journal of industrial medicine, 48(2), 91–99.

12 – Franklin, G., Sabel, J., Jones, C. M., Mai, J., Baumgartner, C., Banta-Green, C. J., Neven, D., & Tauben, D. J. (2015). A comprehensive approach to address the prescription opioid epidemic in Washington State: milestones and lessons learned. American journal of public health, 105(3), 463–469.

13 – Colón, D., Chadarevian, R. (2020). COVID-19’s Impact on Medical Treatment in Workers Compensation—A First Look at 2020. National Council on Compensation Insurance.

14 – National Council on Compensation Insurance. (2022).

15 – Wang, D., Thumula, V., Liu, T-C. (2019). Interstate Variations in Dispensing of Opioids. National Council on Compensation Insurance, 5th Edition. Cambridge, Massachusetts: Workers’ Compensation Research Institute, Update, July 31, 2019, WC-19-26.

16 – National Council on Compensation Insurance. (2017). Medical Data Report Opioid Utilization Supplement For the state of: New Mexico. Update, September 2017.

17 – Neumark, D., Savych, B., Lea R. (2018). The Impact of Opioid Prescriptions on Duration of Temporary Disability. Workers’ Compensation Research Institute, Cambridge, Massachusetts. Update, March 6, 2018, WC-18-18.

18 – Garg, R. K., Fulton-Kehoe, D., Turner, J. A., Bauer, A. M., Wickizer, T., Sullivan, M. D., & Franklin, G. M. (2013). Changes in opioid prescribing for Washington workers’ compensation claimants after implementation of an opioid dosing guideline for chronic noncancer pain: 2004 to 2010. The journal of pain, 14(12), 1620–1628.

19 – Franklin, G. M., Mai, J., Turner, J., Sullivan, M., Wickizer, T., & Fulton-Kehoe, D. (2012). Bending the prescription opioid dosing and mortality curves: impact of the Washington State opioid dosing guideline. American journal of industrial medicine, 55(4), 325–331.

20 – Ben-Shalom, Y., McIntyre, M., Pu, J., Shenk, M., Zhu, W., Shaw, W. (2020). Workers’ Compensation and the Opioid Epidemic – State of the Field in Opioid Prescription Management.

21 – Rothkin, K., Hopkins, E. (2020). Workers’ Compensation Prescription Drug Regulations: A National Inventory, 2020. Update, June, 2020, WC-20-261.

22 – Moss R., Colón D. (2021). Drug Formulary Implementations – A Look at Impact on Workers Compensation Prescription Drug Experience.

23 – Neumark, D., Savych, B. (2021). Effects of Opioid-Related Policies on Opioid Utilization, Nature of Medical Care, and Duration of Disability.

24 – Sears, JM, Haight, JR, Fulton-Kehoe, D, Wickizer, TM, Mai, J, Franklin, GM. Changes in early high-risk opioid prescribing practices after policy interventions in Washington State. Health Serv Res. 2021; 56: 49– 60.

25 – Wise C. (2020). Opioid Prescribing Across Industry Groups.

26 – Thumula, V., Liu, T-C. (2018). Correlates of Opioid Dispensing. Workers’ Compensation Research Institute, Cambridge, Massachusetts. Update, December 2018, WC-18-48.