In its submission to the Naloxone in the Workplace Consultation, Injured Workers Community Legal Clinic (IWC) welcomes and supports efforts to increase workplace safety, including access to naloxone to reduce the risk of deaths caused by opioid overdoses. The Clinic also urges that urges that people who use opioids are not demonized in this review – many workers have a well-managed and appropriate regime of pain killers which may well be the only thing that is effective for them to manage pain and return to some activities of daily living.
The use of opioids connected to the workplace impacts injured workers in individualized ways, but in order to enhance overall safety it is imperative that the Ministry also examines the harmful impacts that certain Workplace Safety and Insurance Board (WSIB) policies and practices have on contributing to potentially unsafe use of opioids:
- The ‘Better At Work’ principles adopted by the Board result in workers all too often being pressured to return to work (RTW) early without adequate time to heal, which increases the risk of reinjury and may stymie rehabilitation. This ‘one-size-fits-all’ approach ignores the need in RTW plans for an individualized assessment based on medical evidence. We recommend that the WSIB restores its previous best practice of ‘Recognizing Time to Heal – Assessing Timely and Safe Return to Work’;
- Listening to the injured worker’s treating doctor – We have seen numerous examples of the WSIB disregarding medical professionals’ opinions about when a worker is ready to safely return to work in favour of a sped-up timeline. We have also heard that treating doctors are often frustrated by the onerous bureaucratic protocols to get Board approval to prescribe opioids for their patient. Unfortunately this, on top of having their professional opinion overridden, causes some doctors to decide not to continue treating the worker. Faced with few options, workers are vulnerable to reliance on unsafe drugs to cope with the demands of a too-early RTW if they can’t continue with their physician-approved prescription opioid treatment;
- Availability of alternative treatments – The healthcare needs of many injured workers who have work-related acute or chronic pain are often not adequately met because of the WSIB’s cuts to healthcare benefits and denial of claims. Without access to alternative treatment, workers turn to opioids to treat their pain. Approval for treatments like physiotherapy can be difficult to get and may only be inadequately short-term unless the worker is prepared to go through what can be years of appeals. Overly restrictive Board policies around approving alternative treatments like medical cannabis only compound the barriers that many injured workers face when trying to manage pain.