title: ACOEM practice guidelines: opioids and safety-sensitive work.
abstract: OBJECTIVE
  ACOEM has updated the treatment guidelines concerning opioids. This report highlights the safety-sensitive work recommendation that has been developed.
  
  
  METHODS
  Comprehensive literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel to develop evidence-based guidance. A total of 12 moderate-quality studies were identified to address motor vehicle crash risk, and none regarding other work among opioid-using patients.
  
  
  RESULTS
  Acute or chronic opioid use is not recommended for patients who perform safety-sensitive jobs. These jobs include operating motor vehicles, other modes of transportation, forklift driving, overhead crane operation, heavy equipment operation and tasks involving high levels of cognitive function and judgment.
  
  
  CONCLUSIONS
  Quality evidence consistently demonstrates increased risk of vehicle crashes and is recommended as the surrogate for other safety-sensitive work tasks.
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Hegmann
authors.forename: Michael S
authors.initials: MS
authors.lastname: Weiss
authors.forename: Kirk
authors.initials: K
authors.lastname: Bowden
authors.forename: Fernando
authors.initials: F
authors.lastname: Branco
authors.forename: Kimberly
authors.initials: K
authors.lastname: DuBrueler
authors.forename: Charl
authors.initials: C
authors.lastname: Els
authors.forename: Steven
authors.initials: S
authors.lastname: Mandel
authors.forename: David W
authors.initials: DW
authors.lastname: McKinney
authors.forename: Rafael
authors.initials: R
authors.lastname: Miguel
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Mueller
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Nadig
authors.forename: Michael I
authors.initials: MI
authors.lastname: Schaffer
authors.forename: Larry
authors.initials: L
authors.lastname: Studt
authors.forename: James B
authors.initials: JB
authors.lastname: Talmage
authors.forename: Russell L
authors.initials: RL
authors.lastname: Travis
authors.forename: Thomas
authors.initials: T
authors.lastname: Winters
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Thiese
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Harris
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D019550:Environmental Medicine / Q000592:standards*; D006282:Health Personnel / Q000592:standards; D006801:Humans; D009787:Occupational Medicine / Q000592:standards*; D009293:Opioid-Related Disorders / Q000517:prevention & control*
chemical_list: D000701:Analgesics, Opioid