PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services CONFIDENTIAL & PROPRIETARY Dawn Motovidlak, CEO Business Health Services Opioids in the Workplace: An Employer's Toolkit

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services The Statistics: In 2009, for the first time, drug overdose deaths in the United States (37,485) surpassed the number of highway crash fatalities (33,808). In 2010, hydrocodone (Vicodin™, an opiate drug used to treat pain) was the most widely-prescribed prescription drug in the United States. Of all overdose deaths in 2008, 55 percent (20,044) involved prescription drugs. Of the prescription overdose deaths, 73.8 percent (14,800) involved opiates. In 2008, there were more than 36,000 drug overdose deaths, equal to the number of suicides (36,035) and more than the number of homicides (17,826) in that year. Quoted from OHS, Feb. 2, 2012, “A New Challenge for Drug Free Workplace Programs”.

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services 3 What are Opioids? Generic/Chemical Names: Natural and natural derivatives include opium, morphine, codeine and heroin (semi-synthetic). Synthetics include meperidine (Demerol), oxymorphone (Numorphan) and oxycodone (Percodan). Distinguishing Characteristics: Opiates are more difficult to clearly describe in terms of form, color, odor, and other physical characteristics. Opium and its derivatives can range from dark brown chunks to white crystals or powders. Depending on the method of intake, they may be in powder, pill or liquid form. Method of Intake: Opiates may be taken in pill form, smoked or injected, depending upon the type of narcotic used.

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services Common Symptoms of Use 4 Constricted Pupils Impaired Coordination Sleepy Appearance Droopy Eyelid Depression, apathy Fatigue, Drowsiness Slow Respiration Lowered Blood Pressure Slowed Pulse Rate Slow or Staggering Gait Euphoria Mood Swings Slurred Speech Slowed Reflexes Loss of Appetite Sweating Nausea, Vomiting, Diarrhea Needle marks or “tracks”; Wearing long sleeves to cover tracks.

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services 5 Addiction and Abuse While many people can take opioid medications without becoming addicted, genetic predisposition and environmental factors lead others to get hooked. Signs of addiction include: Loss of control over medication use Taking medication that was prescribed for another person Taking medication for other reasons besides pain, such as when depressed Building tolerance and steadily needing more of the drug to feel its effects

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services How Does it Affect the Workplace? 6

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services How Does it Affect the Workplace?

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services How Does it Affect the Workplace? 8

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services What can be Done? 9 Employee Assistance Programs Proactive Confidential Assistance Case Monitoring/Management Supervisor Referral Drug Free Workplaces Policy Supervisor Training Testing Employee Education

PROPRIETARY AND CONFIDENTIAL ©2014 Business Health Services 10 DAWN MOTOVIDLAK, PRESIDENT, CEO DIRECT For More Information, please contact me at: