Some Amtrak employees at risk of prescription opioid misuse, inspector general finds
For Immediate Release
October 29, 2020
WASHINGTON – Amtrak could strengthen its ability to detect and deter prescription opioid misuse among employees conducting safety-related work by expanding its random drug testing program, according to an Amtrak Office of Inspector General report released today.
The OIG analyzed de-identified prescription and medical claims from fiscal year 2019 for 11,356 employees who performed safety-related work and found 113 employees who met one or more of the Centers for Disease Control and Prevention indicators of potential opioid use disorder or overdose. For example, the OIG found one conductor who overdosed on opioids at the beginning of the year and subsequently filled seven prescriptions for oxycodone, which put the employee at risk for a future overdose. The OIG also found 68 of the 113 employees had co-prescriptions with benzodiazepines, which are regularly detected with opioids in overdose deaths. In addition, 42 employees had high prescription dosages for the equivalent of at least 10 tablets per day of Vicodin for at least three months.
Further, 1,157 employees, about 10 percent of Amtrak employees in safety-related positions, filled an opioid prescription while they were in an active work status, which put them at risk for being impaired while on the job, the report said. Further, nearly 75 percent of the 3,508 opioid prescriptions filled by employees were for drugs that pose the highest risk for developing an opioid disorder, including fentanyl, hydrocodone, hydromorphone, and oxycodone. Notably, Amtrak does not randomly test for fentanyl.
Amtrak’s main tool to detect and deter drug use is its drug testing program. Key pillars of this program are Amtrak’s zero-tolerance policy for impairment in the workplace and its practice of terminating any active employee who tests positive for illicit drug use. The company also restricts some employees in safety-related positions from using prescription opioids within eight to 12 hours before reporting to work. Amtrak has also implemented recommendations the OIG made in a March 2019 report and strengthened its controls over illicit and prescription drug and alcohol use.
The OIG found in its most recent report, however, that Amtrak could further strengthen its drug testing program by testing more employees who conduct safety-related work and testing for additional prescription drugs. The company limits its random drug testing program to the U.S. Department of Transportation’s minimum requirements for determining which employees to test and what drugs to include.
Currently, the company conducts random drug tests for six prescription opioids that DOT regulates. The testing pool for random drug tests includes about 8,300 employees in safety-sensitive positions, as defined by the DOT, like conductors and engineers. This testing pool does not, however, include about 4,000 other employees who work in positions that the OIG deemed safety related. Such positions include sheet metal mechanics, onboard service attendants, welders, and yardmasters—employees responsible for the safe movement of trains and railcars within a railyard.
The DOT permits rail carriers to test more employees and test for more drugs than its regulations require, and the National Transportation Safety Board recommends randomly testing all employees in positions that could affect employee safety or the safety of others.
Amtrak, however, has not assessed its workforce to determine which additional positions it deems to be safety-related, whether to add these positions to its testing, and whether it is testing for the most relevant prescription opioids. While company managers told the OIG they see value in expanding the random testing program, they noted such changes would require union approval for any positions covered by collective bargaining agreements.
To address the report’s findings, the OIG recommended that the company identify all positions in which employees’ use of prescription opioids could impair their ability to safely perform job-related tasks and that the company identify whether additional prescription opioids are of substantial concern for safety-related work. Additionally, it recommended that the company then develop a strategy to negotiate with unions to expand its random drug testing program to cover these additional positions and any additional opioids. The company agreed with the OIG’s recommendations.
More findings and recommendations are included in the full report which can be downloaded on the OIG’s website: https://direc.to/fg7o.