American College of Occupational and Environmental Medicine

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Released February 24, 2014

Don’t prescribe opioids for treatment of chronic or acute pain for workers who perform safety-sensitive jobs such as operating motor vehicles, forklifts, cranes or other heavy equipment.

The use of both strong and weak opioids has been consistently associated with increased risk of motor vehicle crashes as opioids produce sedation and hinder or impair higher cognitive function. Evidence suggests higher risk with acute opioid use, but risk remains elevated throughout treatment with any opioid and reverses on cessation. Workers who operate motor vehicles/heavy equipment should be precluded from performing these or other safety-sensitive job functions while under treatment with opioids.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American College of Occupational and Environmental Medicine (ACOEM) routinely develops evidence-based clinical practice guidelines to assist physicians in improving or restoring the health of those workers who incur occupationally related illnesses or injuries. ACOEM’s Practice Guidelines, developed by expert panels, are the gold standard in effective treatment of occupational injuries and illnesses and are the only evidence-based guidelines that focus on returning employees to work within 90 days of an injury or illness. In addition, the College promotes the high-quality practice of occupational and environmental medicine (OEM) through the publication, via the scientific peer-reviewed Journal of Occupational and Environmental Medicine, of position statements and guidance documents relevant to the field. These documents are developed by ACOEM task forces made up of physician member volunteers and are approved by the Board of Directors.

After input from ACOEM leaders and approval from the Board of Directors, five topics were selected from the Practice Guidelines and the ACOEM position paper on fatigue risk management in the workplace for this campaign. The position paper and the methodology for the development of the Practice Guidelines are available at www.acoem.org.

ACOEM’s disclosure and conflict of interest policy can be found at www.acoem.org.

Sources

Weiss MS, Bowden K, Branco F, et al. Opioids Guideline [Internet]. In: Hegmann K, ed. ACOEM’s Occupational Medicine Practice Guidelines. 3rd ed revised. Westminster, CO: Reed Group Ltd. Forthcoming 2014 March. p. 11.