Opioid Overdose Drugs Unite Groups Over Workplace First Aid Kits

Reducing the number of on-the-job opioid deaths is the goal of of workplace safety advocates and industry groups that want businesses to include an overdose prevention drug—Naloxone—in their first aid supplies.

A significant roadblock to employers stocking Naloxone was lifted this year as the Food and Drug Administration approved two nasal spray versions of Naloxone—Narcan and RiVive—as non-prescription drugs that can be sold in stores or online.

“Whether as part of a first aid kit or elsewhere, Naloxone serves as another tool in the toolkit to help keep workers safe,” Lorraine Martin, president of the National Safety Council, said. “Now that it is available over the counter, Naloxone should be in every workplace.”

The push comes as the US continues to grapple with an opioid crisis that has claimed thousands of lives nationwide.

In workplaces, unintentional drug overdoses, such as from fentanyl, led to 464 occupational deaths in 2021, according to US Bureau of Labor Statistics data. That’s 9% percent of the year’s 5,190 on-the-job fatalities and the fifth most common cause. Transportation, warehousing, and construction workers accounted for 42% of the deaths.

While a voluntary industry standard could potentially materialize in the next few years, some employers are already moving ahead with plans to have Naloxone at their worksites.

For example, efforts are underway at Amazon.com Inc. to ensure the drug is available at the online retailer’s facilities, according to Maureen Lynch Vogel, a spokesperson for the company’s global safety program.

The US Occupational Safety and Health Administration doesn’t issue first aid kit content lists for most employers.

Instead, OSHA references the recommendations in the industry consensus standard for first aid kits—ANSI/ISEA Z308.1.

Todd VanHouten, chair of the committee that oversees the standard, the International Safety Equipment Association’s First Aid Product Group, said he expects inclusion of Naloxone to be on the committee’s agenda when it meets later this year.

“There’s a case to be made that it should be in every first aid cabinet,” VanHouten said.

A question for the committee could be whether the standard would require Naloxone for some industries—such as those with greater overdose numbers—while just recommending it for industries with few cases, VanHouten said.

If the committee agrees to include Naloxone in its first aid kit standard, the soonest the change would be published is likely 2025, he said.

The Narcan version of Naloxone will have a suggested retail price of about $45 for a package containing two doses and be available in September, the drug’s manufacturer Emergent BioSolutions Inc. said Wednesday.

The Associated General Contractors of America recommends stocking Naloxone and several chapters have working with local agencies to implement programs, according to Brian Turmail, the commercial construction industry group’s vice president for public affairs.

One of the US’s largest providers of employer first aid kit services is Cintas Corp. in Cincinnati. The company’s vice president of corporation communications, Michelle Goret, said customers have asked if Naloxone will be added to their supplies, and the company is looking at whether to do so.

A question often raised by employers is what liability they would face if they administered Naloxone to a worker or anyone else showing symptoms of an overdose.

Attorney Christina Kamelhair, of counsel with Ogletree, Deakins, Nash, Smoak & Stewart P.C. in Indianapolis, said states have stepped in to protect employers administering the drug.

“All 50 states, at this point, have enacted Good Samaritan laws or Naloxone access laws, or both,” Kamelhair said. “That’s going to shield employers or individuals from liability for administering that drug.”

Dr. L. Casey Chosewood, director of the National Institute of Occupational Safety and Health’s Total Worker Health Program, said the over-the-counter approval should reassure employers about the drug’s safety, even if the drug is administered to a person who became unconscious for a reason other than a drug overdose.

“Having Naloxone available is all upside,” Chosewood said. “You’re not going to add any addition harm to that person by using it in that setting.”

Chosewood added that employees’ first action in responding to a possible overdose should be calling 911 and requesting an ambulance.

Another concern for employers is whether administering Naloxone to a worker would trigger OSHA’s requirements for recording a workplace injury or illness in an OSHA-mandated log.

In a statement to Bloomberg Law, OSHA said that treating a employee with over-the-counter Naloxone wouldn’t by itself have to be recorded in OSHA-mandated logs, since non-prescription drugs are exempted from the requirement and their use is considered to be first aid.

However, OSHA said, the case “may become recordable when administered in conjunction” with other criteria for recording injuries and illnesses.

OSHA’s recording rule tells employers that “you must record a work-related injury or illness if the worker becomes unconscious, regardless of the length of time the employee remains unconscious.”

Naloxone advocates recommended employers ensure whoever they designate to administer the drug gets training.

Beyond administering the drug, the training should include CPR, recognizing the signs of a worker suffering a drug overdose, and how to respond besides using the Naloxone.

Free training is often available through local health departments and social service agencies.

“Education on Naloxone administration can take as little as 10 minutes,” NSC’s Martin said. “Ten minutes is a fraction of a typical busy day, and that’s all the time it takes to learn how to save a life.”

To contact the reporter on this story: Bruce Rolfsen in Washington at [email protected]

To contact the editors responsible for this story: Jay-Anne B. Casuga at [email protected]; Genevieve Douglas at [email protected]

AI-powered legal analytics, workflow tools and premium legal & business news.

Log in to keep reading or access research tools.