Employees of several federal agencies, including the Customs and Border Protection, Immigration and Customs Enforcement (ICE), Transportation Security Administration (TSA), and Secret Service will receive the same disciplinary measures for prescription opioid use as illegal use if taking opioids impairs their ability to perform job duties. According to the Department of Homeland Security (DHS) inspector general (IG), of more than 100,000 randomized tests in the three-year span between 2015 and 2018, only 31 returned positive results. However, these tests only accounted for illegal use.
Historically, medical review officers at drug testing labs have not been required to report positive test results to federal agencies if users can document a prescription or other valid medical explanation. This meant that those who could were off the hook. However, this is about to change.
ICE has started requiring labs to notify the agency when the positive results are due to a prescription and the Secret Service will soon be doing the same. The TSA also now requires employees with legal opioid prescriptions to take a “fitness for duty” test. The main point is, prescription and non-prescription opioid use should be treated similarly because both induce similar symptoms, and all other agencies are also in the process of moving in this direction.
The “fitness for duty” testing will help ensure the government’s workforces are “capable of effectively performing their duties,” the IG said, “while providing consistent standards that allow employees to use legally prescribed medications.” The agencies have had measures in place to reprimand workers that are not fit for duty even with prescription opioids for some time, but the general penalty guidelines are in the process of being updated to account for the most recent changes. So far, ICE, TSA and Secret Service “have taken steps to clarify expectations that prescription drug use affecting employees’ work performance will not be tolerated.”
Of course, cracking down on legal opioid use is a delicate balancing act. “Agencies are navigating difficult terrain,” the IG said, as “they must balance the rights of employees to use legally prescribed opioids with their obligation to ensure their workforce is alert, responsible and effective.”
In August, federal employees receiving workers’ compensation benefits were limited to opioid prescriptions in seven-day increments, up to 28 days. The Federal Employee Health Benefits Program is the world’s largest health plan, covering an estimated 9 million people, including federal workers, retirees, and their family members. The new policy placed restrictions on short-term pain relief while continuing to ensure those with cancer and other chronic conditions have access to their prescriptions.
Under the new policy, all opioid prescriptions extending beyond one month must be accompanied with a letter from a clinician validating medical need, which would authorize only two additional thirty-day supplies. This allows for those suffering from chronic conditions to continue receiving pain relievers. Still, many believe that the new restrictions are too rigid for patients who really need pain relief and they fear the laws will prevent those who already face significant barriers from receiving proper treatment.