Correlation between Kentucky’s opioid crisis and workplace violence in healthcare


By Scott Cormier

One of the fastest growing issues in the healthcare setting is workplace violence. In fact, according to OSHA, 75 percent of nearly 25,000 workplace assaults reported annually occurred in healthcare and social service settings.

In turn, the International Journal of Nursing Studies surveyed 26,979 nurses and found that 50 percent reported experiencing one episode of violence within the past year. Of those, approximately 19 percent reported acts of physical violence.

Workplace violence isn’t confined to one specific action–violence can be defined as raising one’s voice, bullying, physical assault or any threatening act against another individual. To maintain a safe environment for all, hospitals and health systems in Kentucky should understand the risks and be aware of triggers that could instigate violence.

Many can be quick to assume that workplace violence only occurs between co-workers. However, the same OSHA study found that 80 percent of these workplace incidents in healthcare actually stem from patients. These assaults remain grossly underreported as well.

Workplace Violence Not New

Unfortunately, encountering this type of violence in healthcare isn’t something new. In 2018, members of the Kentucky Nurses Association, the voice of nurses in Kentucky, decided that enough was enough. Nurse leaders and administrators from across the state came together to initiate the dialogue about healthcare workplace violence, determining both the possible risk factors of violence and necessary plans of action.

Patients and family members tend to be in distress when at the hospital, which causes heightened emotions and reactions. However, the Kentucky Nurses Association found that there are several other factors that contribute to workplace violence in healthcare – including the rising misuse of opioids. And Kentucky, sadly, is no stranger to this crisis.

Kentucky is among the top ten states with the highest opioid-related overdose deaths, according to the National Institute on Drug Abuse (NIDA).

Kentucky’s opioid crisis has a long history. The NIDA states, “Since 2012, overdose deaths related to heroin have increased from 143 to 311 and deaths related to synthetic opioids have increased from 70 to 465.” Not to mention that in 2015, Kentucky healthcare providers wrote 97 opioid prescriptions per 100 people–the average U.S. rate that year was 70 per 100 people.

With the nation’s opioid crisis continuing to rise at an alarming rate, healthcare workers who provide care in Kentucky are left treating patients that may be under the influence of drugs or experiencing their side effects. This increases the risk of violence as opioids have the ability to send users into a state of severe psychosis, causing aggressive behaviors such as physical agitation and irritation that could be taken out on caregivers.

Hospitals and health systems are also home to several prescription opioids. The addictive nature of drugs such as oxycodone, hydrocodone and morphine can cause users to go to great lengths to feed their intense addiction. This may include threatening or bullying healthcare workers into giving them what they want. Likewise, patients may become irate if they are denied a prescription, which could lead to further violence.

Violence against nurses is a class IV misdemeanor in Kentucky. It is crucial that healthcare facilities, their associates and caregivers implement strong preventative measures along with advanced protocol to make their healing environment a safe place for all.

The good news is that your facility doesn’t have to go it alone. Here are three ways your facility can minimize the physical threat of workplace violence stemming from opioid abuse.

  1. Implement a threat assessment team.

Consider implementing a threat assessment team to ensure safety throughout the facility. Comprised of current employees, behavioral health professionals, law enforcement, facility administrators and counselors, this important group is responsible for addressing concerns about threatening or potentially threatening behavior that could result in violence.

  1. Evaluate the risks.

Risk factors must be identified in advance in order to see the bigger picture. Ask questions about your specific organization and the likelihood for such occurrences to take place. For example, is the workplace located in an area with a high drug rate? Do employees deal with people known or suspected to have a history of violence and opioid use? When factors such as these are considered, healthcare workers are more likely to be protected from potentially violent incidents.

  1. End the abuse.

The NIDA found that “roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.” Opioids do relieve physical pain, yes, but the risk of abusing them once they are no longer needed is severe. Merely denying opioids or even sending the patient to a rehabilitation program may not end the abuse if pain management is not part of the treatment program. Your facility needs a comprehensive plan made by doctors, nurses and other providers to establish pain management throughout the life of an opioid abuse treatment plan.

Understanding how Kentucky’s growing opioid crisis has affected safety in the healthcare setting is important in knowing how to reduce violence within it. Remember, if you witness workplace violence or opioid misuse in your community, speak out and speak up.

-Scott Cormier is the vice president of Emergency Management, Environment of Care (EOC) and Safety at Medxcel.



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