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Drug Abuse Aware And Prepared
by Cris Zimmerman, RDH, BS
The opioid crisis brings a new risk to today’s dental practices for both patients and employees
The opioid problem has become a nationwide epidemic, affecting every generation, gender, race, income level, and profession. This epidemic is affecting all areas of the workforce, including the dental profession. It’s a harsh reality for those in management positions who are trying to maintain a safe and professional work environment.
There are many indicators that you can watch for to reveal if a person is abusing drugs. And, it’s important to know that the recommended urine or blood tests are not fail-proof resources for determining if a suspected employee may have a drug problem.
Consider some lessons I’ve learned in my own work, as a dental hygienist, and in discussions with professional peers.
One manager shared her experience with an employee who started to show a decline in her work skills and personal appearance. This staff member was a great employee when she was first hired. However, the manager started to notice a rapid change in her appearance and work ethic. Furthermore, her behavior became peculiar, hiding things where no one else would even think to look for them. She was fidgety and appeared nervous. She tried very hard to come across as confident with a leadership desire but the actions didn’t line up with her words. She began to develop sores on her face that she claimed was a form of acne, but the manager knew it was nothing like the acne she had experienced or seen. A number of people approached the manager with genuine concern and compassion, including patients, who genuinely cared for the employee in question. They too, had noticed alarming changes. The manager was unaware these issues were indicators of a drug problem until it was brought to her attention.
Ultimately, the manager used her state’s online substance abuse reporting system to check the employee’s history of narcotic prescriptions, a resource typically used by medical practices to protect themselves from drug-seeking patients. The manager took this step after the employee in question had requested pain medications from the practice. The manager was shocked to learn that many prescriptions for controlled substances had been prescribed to the employee and her husband from her practice.
In another case, a manager assumed that if he sent an employee for drug testing, the results would conclude whether or not an employee was abusing narcotics. After sending an employee for two separate drug tests, and knowing from other team members that this person was, in fact, abusing narcotics, the employee passed both tests. The manager knew, from my other sources, that another one of his employees was snorting pain killers, abusing other drugs and bragging about it to co-workers. He needed proof in order to fire the employee. He contacted the lab and asked if the employee’s tests were supervised because he figured he must have taken someone else’s urine with him. The lab personnel assured the manager that the second test was supervised. The manager further inquired how it was possible for someone to pass a urine test when they were likely abusing drugs. He was told that if someone has a prescription for Adderall or a similar methamphetamine drug, the lab looks at the prescription history and automatically gives a pass on anything in that category. The result would have been the same if he had sent the employee for a blood test, which costs more, and was his next course of action.
It is disheartening to see what any form of addiction can do to a wonderful person and competent employee. Any number of devastating issues can contribute to drug abuse. However, it’s important for dental practices to be aware of the risks. Patients trust in our care and should feel confident that the employer will hire capable team members to deliver the standard of care they need and deserve.
An impaired dental assistant puts themselves, the practice, and the patient at risk. The onus is on managers to be aware of opioid and other drug abuse and have systems in place to identify employees who may be at risk or are already abusing drugs. Generally, drug problems begin with pain medications which becomes too costly and difficult to continue. Consequently, this leads abusers to seek out heroin and other dangerous drugs. Medical/dental professionals are catching on and monitoring the amount of prescription drugs they prescribe. Dentists are now required to take at least one hour of continuing education on prescribing controlled substances.
The North Carolina Controlled Substance Reporting website is an excellent resource. Bear in mind, there are strict rules for the how the site can be utilized. North Carolina dentists will soon be required to be listed on this site and required to look up any patient before they provide a controlled substance and also document that prescription on the patient’s online chart.
Be aware of what is going on in your community and workplace. Be sure to look further into the rules of employment within your local employment security commissions and remember that you can’t single out one employee for drug testing. At my own practice, it has become our policy that all employee candidates are drug screened prior to employment, although, as noted, these tests aren’t without flaws. I have adopted a policy that was given to me from a mentor: Be slow to hire and quick to fire. Obviously, we aren’t going to fire unless there is reasonable, documented cause, but always act in the best interest of the work environment for patients and the rest of the team.
Cris Zimmerman, RDH, BS -- Dental Hygienist and Office Manager, Cris Zimmerman, RDH, BS has worked in dentistry over 26 years and is still passionate about her profession. Cris longs to make a difference in the field she loves by giving others the tools to make their team thrive together. She has a twenty-eight-year-old daughter and eighteen-year-old son. She lives in Jacksonville, NC and has been happily married to her best friend for 7 years. She can be reached at [email protected]
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