In Focus Blog – Published on: November 30, 2018

CDC Data: Life Expectancy Decreases as Deaths From Suicide, Drug Overdose Increase

Laura Joszt

New reports from the CDC have highlighted troubling increasing trends in suicides and drug overdose rates as life expectancy in the United States declined.

New reports from the CDC have highlighted troubling increasing trends in suicides and drug overdose rates as life expectancy in the United States declined.

 

In 2017, the life expectancy for someone at birth in the United States was 78.6 years, which is a slight decline from 78.7 years in 2016.1 At age 65, the life expectancy for the total population was 19.5 years, which was a slightly increased from 2016 (19.4 years).

 

Life expectancy for females is consistently higher than it is for males. While total life expectancy for males had decreased from 76.2 years in 2016 to 76.1 years in 2017, female life expectancy stayed the same at 81.1 years. At age 65, the difference in life expectancy between females and males narrowed slightly to 2.5 years (20.6 years for females and 18.1 years for males).

 

The report showed that death rates for some age groups increased significantly year over year. The death rate for the 25 to 34 age group increased the most (2.9%), followed by the 35 to 44 age group (1.6%) and the 85 and over age group (1.4%). In comparison, the death rate decreased 1% for the 45 to 54 age group.

 

From 2016 to 2017 the 10 leading causes of death remained the same: heart diseases, cancer, unintentional injuries, chronic lower respiratory diseases, stroke, Alzheimer disease, diabetes, influenza and pneumonia, kidney disease, and suicide. Age-adjusted death rates increased for 7 of the 10 causes with the rate increasing the most for influenza and pneumonia (5.9%), unintentional injuries (4.2%), and suicide (3.7%). The rate for cancer decreased 2.1%, while the rates for heart disease and kidney disease did not change significantly.

 

A separate report delved specifically into drug overdose deaths from 1999 to 2017, and it found that there were 70,237 drug overdose deaths in the United States in 2017.2 The age-adjusted rate of drug overdoses was 9.6% higher in 2017 compared with 2016.

 

There had been a sharp increase in overdose deaths involving synthetic opioids, such as fentanyl, fentanyl analogs, and tramadol, from 2016 to 2017. The age-adjusted rate of drug overdose deaths involving synthetic opioids other than methadone increased by 45%. The report highlighted how steep the increase was over the years. While the average rate of drug overdose deaths involving synthetic opioids increased by 8% per year from 1999 to 2013, the average rate increased by 71% per year from 2013 to 2017.

 

There were 20 states, plus the District of Columbia, that had drug overdose death rates higher than the national rate in 2017. West Virginia (57.8 deaths per 100,000 people), Ohio (46.3), and Pennsylvania (44.3) had the highest age-adjusted drug overdose rates, while Texas (10.5), North Dakota (9.2), South Dakota (8.5), and Nebraska (8.1) had the lowest death rates.

 

Rates of drug overdose deaths are significantly higher for males than females. The rate for males increased from 8.2 per 100,000 standardized population in 1999 to 29.1 in 2017. For females, the rate increased from 3.9 to 14.4. However, the rate for females increased more sharply.

 

“The latest CDC data show that the US life expectancy has declined over the past few years,” Robert R. Redfield, MD, CDC director, said in a statement. “Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide. Life expectancy gives us a snapshot of the nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable.”

 

References

1. Murphy SL, Xu JQ, Kochanek KD, Arias E. Mortality in the United States, 2017. NCHS Data Brief, no 328. Hyattsville, MD: National Center for Health Statistics. 2018.

2. Hedegaard H, Miniño AM, Warner M. Drug overdose deaths in the United States, 1999–2017. NCHS Data Brief, no 329. Hyattsville, MD: National Center for Health Statistics. 2018.

 

 

2019 Random Drug Testing Rate Increase

As mandated by its drug and alcohol regulation, FTA will increase the minimum rate of random drug testing from 25 percent to 50 percent of covered employees for employers subject to FTA’s drug and alcohol regulation, effective January 1, 2019. This change is due to an increase in the industry’s ‘‘positive rate’’ as reflected in random drug test data for calendar year 2017.

For further information go to: https://www.transit.dot.gov/sites/fta.dot.gov/files/docs/regulations-and-guidance/ccam/policies-programs/118686/fta-dear-colleague-letter-2019-random-drug-testing-rate-increase-final-10-17-18.pdf

copied from WELLCOA 

 

SUBSTANCE ABUSE AND WORKPLACE WELLNESS

Barbara J. Zabawa

President of the Center for Health and Wellness Law, LLC

 

Companies that embrace workplace wellness may naturally want to also address substance abuse issues in the workplace. After all, substance abuse can undermine wellness efforts, both at the individual and organizational level. Aligning workplace wellness with employee substance abuse issues may be even more urgent given the current opioid crisis in our country. According to a Blue Cross Blue Shield claims analysis in 2017, opioid disorder diagnoses increased about 500% over the past 7 years. According to a 2013 study by the federal Substance Abuse and Mental Health Services Administration, of the 22.4 million illicit drug users aged 18 or older in 2013, about 70% are employed either full-time or part-time. Minimizing employee substance abuse may improve employee productivity, reduce absenteeism, accidents and injuries and decrease medical benefit costs. According to one analysis, workplace substance abuse prevention programs are associated with reduced illicit drug use.

Employers have attempted to tackle substance abuse in the workplace through a number of methods, including drug testing programs, training of managers to recognize the signs of substance abuse, substance abuse policies, coverage for rehabilitation, and Employee Assistance Programs (EAPs). Employers may also consider weaving substance abuse detection and help into a workplace wellness program. Before going down that road, however, it is important for wellness program leaders to understand the laws governing substance abuse in the workplace. This blog explores the Americans with Disabilities Act (ADA) provisions that may affect workplace wellness programs, though other laws may also apply. These other laws may include state laws, the Family Medical Leave Act, and other civil rights and privacy laws.

ADA AND SUBSTANCE ABUSE EFFORTS IN WORKPLACE WELLNESS

A basic question for workplace wellness program leaders is whether questions about substance abuse can be included in a health risk assessment or tests for the presence of drugs can be included in a biometric screen. Recall that the ADA generally prohibits requiring employees to undergo “medical exams” (which would include most traditional HRAs and biometric screens) unless an exception applies. 42 USC § 12112(d). One exception relates to whether the medical exam is job-related and consistent with business necessity. That exception does not apply to workplace wellness programs. The other exception does apply to workplace wellness programs and permits medical exams that are voluntary and part of an employee wellness program.

This exception permits an HRA to include questions about an employee’s drug or alcohol use as part of a voluntary wellness program. The thornier issue is how to address employee responses to those drug and alcohol use questions. What if an employee admits to currently using illicit drugs, or identifies as an alcoholic? How should the workplace wellness program leaders respond, particularly if the employer has a drug-free workplace policy?

ILLICIT DRUG USE NOT PROTECTED

The ADA does not protect employees or applicants who are current illicit drug users (whether those drugs are illegal or prescribed drugs being used illegally). Indeed, testing for illegal drugs is not considered a “medical exam” under the ADA. 42 USC § 12114(d). Thus, a wellness program that reveals an employee who currently uses illicit drugs would not violate the ADA by informing the employer about the substance abuse because illegal drug use is not protected by the ADA. However, informing the employer may undermine employees’ willingness to be truthful and accurate in responding to HRA questions, which in turn may undermine the ability for the wellness program to help employees lead healthier lives. Wellness program leaders should consider the importance of gaining employee trust when administering HRAs or biometric screens, as privacy concerns are a big reason why employees refuse to participate in wellness programs.

Employers have attempted to tackle substance abuse in the workplace through a number of methods, including drug testing programs, training of managers to recognize the signs of substance abuse, substance abuse policies, coverage for rehabilitation, and Employee Assistance Programs (EAPs).

ALCOHOLISM IS PROTECTED

As for when an HRA respondent admits to being an alcoholic, the ADA considers alcoholism a disability that warrants protection from discrimination. Thus, an HRA that reveals employees who are alcoholics would be subject to the ADA’s confidentiality protections. Those protections require medical information collected from a medical exam to be treated as a confidential medical record, stored separately from the employee’s personnel file, and should not be shared with the employee’s supervisors or managers unless it is necessary for purposes of imposing work restrictions or making necessary accommodations. 42 USC § 12112(d)(3). As long as the alcoholic is otherwise qualified for his or her job and does not violate the employer’s drug or alcohol policy, the ADA would protect that employee from discrimination by the employer.

CONCLUSION

Employers may try to use their workplace wellness programs to address the growing concern with substance abuse in the workplace. Although the ADA permits inquiries into substance abuse as part of a voluntary wellness program, wellness program leaders must understand the limits and protections of the ADA for substance abusers who participate in wellness programs. Wellness program leaders should also consider the consequence of informing employers of wellness program test results. Even though disclosure may be legal under the ADA in some circumstances, employees may lose trust in the program and either refuse to participate, or not be truthful when answering health questions. In any case, wellness programs seeking to integrate drug-free workplace initiatives should consult with legal counsel to ensure that the integration is compliant and goes smoothly.

 

In an article published by DATIA (Drug and Alcohol Testing Industry Association) sums up the issues in the workplace with opiods ad prescription drugs. The information was taken from the an article done by the National Safety Council Addresses Opioids and Prescription Drug Abuse in the Workplace

According to a recent survey by the National Safety Council (NSC), over 70% of employers are impacted by employee use of prescription drugs. In addition, according to the Center for Disease Control, the death rate for opioid overdoses is steadily increasing with more than half involving prescription opioids. Clearly, the nationwide opioid epidemic is impacting workplaces in a major way.

Those involved in providing safe and drug free workplace programs and drug testing programs should be prudent in addressing this increasingly important issue. Employers not addressing the issue within their workplace should be provided with information on how the epidemic may be impacting their workplace so that they may take proactive measures to establish a drug free workplace program. Two such tools for employers from the NSC are the Proactive Role Employers Can Take: Opioids In the Workplace and the Prescription Drug Employer Tool Kit.

DATIA will continue to keep its members abreast of the nationwide opioid epidemic and share tools that may be used when addressing the issue with clients and drug testing programs.

Information copied from DATIA eNews on June 15, 2017