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Pallet C e nt ral • No vem be r-D e cem be r 2 0 26 4 3 commercial name for naloxone, rarely did employers include this and other types of OORMs in their first aid kits for emergency response. When it comes to an opiate overdose, time is definitely of the essence. Moreover, if a high level of opiate has been consumed, multiple doses of the OORM may be needed to revive the individual—and keep them revived. e two FDA-approved OORMs are naloxone and nalmefene, which are sold under multiple brand names. Some naloxone sprays are available without prescription through retail outlets. I have obtained doses free of charge by taking training from my state's health department, and some associations bring in trainers and provide free samples at construction, mining, safety, and manufacturing conferences. e nasal spray types are most accessible. ere are also injectable forms of OORMs, but those are typically used by first responders and health care workers. is medication is injected through a vein, into a muscle, or under the skin. It is critical to note the storage requirements for these products, keeping them away from direct sunlight or excessive heat. Do not freeze the medication. Employers must also track the expiration dates of the products and ensure that they are restocked after use. Employees need to know which type of OORM you keep on site and be trained in how to use it effectively. ey also need to protect themselves. A legitimate issue of concern among employers who may want to help is cross-contamination. e first responder (or co-worker) can accidentally contact opiates such as fentanyl while attempting CPR, rescue breathing, or site cleanup. While workers may have training on OSHA's Bloodborne Pathogen protocols, dealing with high concentration opiates in an emergency situation is quite a different story (although the breathing barriers and use of protective gloves can still be useful), and management of the scene should be undertaken by professional first responders or others with training. Another concern that can arise is personal liability if the employee tries, but fails, to revive the co-worker or other individual in the workplace. Most states have "Good Samaritan" laws to protect those who help someone during an overdose. But be aware that if police become involved in investigating a workplace overdose or if OSHA investigates it as a workplace fatality, there may be other legal consequences—particularly if drug dealing is traced back to the workplace. OSHA does need to be notified if an employee is hospitalized with an overdose (notification within 24 hours of the event) or if the worker dies (within 8 hours of the event for federal OSHA, sooner in some states). OSHA does not have any laws specifically banning drug use in the workplace, but if the employer knew or should have known and took no action to mitigate harm, the company could be held liable under OSHA's General Duty Clause, Section 5(a)(1) of the OSH Act. For those who might perform work on worksites regulated by the Mine Safety & Health Administration (MSHA), including delivering or picking up pallets at cement plants, stone, sand or gravel operations, there are more severe consequences. I recently handled a fatal fentanyl overdose case at a quarry, where the worker died in a porta-john and was found at the end of shift. MSHA did indeed cite the employer and issue a civil penalty. e company was also cited for not timely reporting the death (MSHA has a 15-minute reporting deadline, which applies to visiting companies whose workers die on a mine site). Mandating OORMs is not federal law, but there could be a trend at the state or local level. e New York State Department of Labor, for example, has proposed regulations that would require certain employers to make an OORM available for workplace first aid or emergency treatment. e covered employers would need to recruit workforce volunteers and establish inspection, replacement, and disposal practices before the statute takes effect on December 13, 2026. ere is no exception under the state proposal for industry, employer size, or perceived risk. Employers would analyze their obligations under applicable federal first aid standards, and even some office and retail locations will be covered. e bottom line is that the U.S. Department of Labor has signaled its expectations that employers will become partners in fighting the opiate overdoses. ere is no new legal requirement for drug testing, nor will an employer be cited for not having OORMs as part of their first aid provisions. But it's the right thing to do. Rescuing workers allow for treatment and rehabilitation. Employees who do experience a workplace incident should be treated with respect and encouraged to get help. Drug addiction is covered under the Americans with Disabilities Act, but only those in recovery have protections (not active illegal drug users). With successful treatment, those individuals should be encouraged to return as a productive member of the workforce. Adele Abrams, Esq., ASP, CMSP, is Senior Counsel in the Washington, DC, office of Liler Mendelson PC, where she is part of the firm's Occupational Safety and Health group and leads the national MSHA practice. Adele provides OSHA/MSHA case representation, training, and consultative services on safety and employment law. She can be reached at Aabrams@liler.com or 301-613-7498.

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