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IG: USPS Is Putting Injured Workers at Risk by Failing to Adequately Reduce Opioid Use

Average number of opioid prescriptions per injured employee has climbed over last few years, despite nationwide cuts.

Nearly 3% of U.S. Postal Service employees received opioid prescriptions as a result of injuries sustained on the job, according to a new report, and the average number of such prescriptions per injured worker actually increased over the last several years.

The USPS inspector general flagged those figures as troubling given the current opioid crisis in the country and the nationwide efforts to cut back on prescriptions for the pain medications. The Postal Service provided the drugs through the Federal Employee Compensation Act’s worker compensation program. The mailing agency’s spending on opioids in 2018 dropped compared to two years prior, the IG found, but the decline was only 70% of that seen at other federal agencies.

Across the country, opioid prescriptions decreased by 21% from 2013 to 2017, but by just 9% at the Postal Service. All told, nearly 18,000 postal employees received more than 119,000 opioid prescriptions through FECA in 2018. The prescriptions per employee jumped from 6.2 to 6.8 from 2014 to 2017, despite a drop off at the national level.

“An increasing number of prescriptions per employee could indicate an increased risk of opioid misuse,” the IG said, noting postal employees could receive additional prescriptions outside the FECA program. Postal management disagreed with the IG’s comparisons to the federal and private sector workforce, saying the makeup of the postal workforce was fundamentally different and the physical nature of their work led to more injuries requiring opioids. 

The IG questioned the controls on the FECA program, highlighting the dozens of employees who have received more than 200 opioid prescriptions over the last six years. Nearly 1,300 employees received more than 100 prescriptions, while four workers received more than 400.

USPS human resources does not use FECA data to monitor opioid use, the IG found. The auditors said postal headquarters should be monitoring trends among its employees and identify specific locations or offices where problems may be cropping up. Such monitoring is particularly important, they said, because the Labor Department, which administers FECA, allows doctors to prescribe opioids “without a letter of medical necessity” for up to 60 days.

“When the Postal Service does not use data analysis, it cannot assess and anticipate any associated workforce issues and take targeted action to help protect its employees and customers from the dangers of prescription drug addiction,” the IG said.

The IG suggested a quarterly review of the FECA data and postal management said it would begin to review the information.

Still, the auditors said USPS did not maintain an adequate policy for handling employees using opioids or for educating them about the risks associated with the drugs. The Postal Service initiated “stand-up talks” during the IG’s review, but did not document attendance or explain the agency’s rules regarding prescription drug use in the workplace. USPS must better equip its managers to respond to employees using opioids to “ensure staff taking prescription drugs that could impair their mental or physical abilities do not perform activities, such as driving or working around heavy equipment, putting themselves and others at risk,” the IG said.

In fiscal 2019, the Labor Department set a new goal to reduce initial opioid prescriptions and the duration of the prescriptions by 30% compared to fiscal 2016 levels. Labor has also pledged to place restrictions on new opioid prescriptions to give federal employees just seven days to fill them, instead of 60, and to require prior approval for continued use past 30 days. The postal IG said the mailing agency should work with Labor to oversee the implementation of those guidelines.

Postal management agreed to do so, but declined to follow a recommendation to create a new, comprehensive drug abuse and addiction program to replace its existing efforts. Dave Partenheimer, a USPS spokesman, stressed the agency has no direct involvement in what prescriptions employees receive. 

"The national opioid epidemic is of great concern to the U.S. Postal Service and its employees and we will continue to communicate the dangers and risks associated with the use of prescription opioids to our employees," Partenheimer said, adding any "meaningful changes" to the FECA program must be carried out by the Labor Department and not USPS. 

This story was updated with additional comment from the Postal Service