OTC Strategies

To address the problem of OTC medications in the workplace, employers should take a number of steps:

1. First, educate employees to the problems of OTC medications and how to address them. The program should include information on the following, at minimum:

a. The importance of getting a sufficient amount of sleep.
b. The importance of taking prescription medication and OTC medicines as prescribed by physicians and/or on the packages.
c. How to identify side effects they may be experiencing.
d. The importance of checking with their physicians if they do experience side effects.
e. The importance of telling their supervisors if they feel impaired as a result of medications, lack of sleep or other causes.

2. In terms of working with physicians, for example, there may be some viable alternatives to OTC medications that cause impairment. “For instance, first-generation antihistamines, which are now largely OTC, tend to cause drowsiness,” explains Lynne Stebbins, R.N., president and CEO of Stebbins Safety Services Inc. in Freehold, N.J. “Employees should check with their physicians to see about getting prescriptions for second-generation antihistamines, which are nondrowsy (formulas).” That is, first-generation (OTC) antihistamines can cause drowsiness, impaired coordination, inability to concentrate and dizziness. Second-generation antihistamines, most notably the three industry leaders – Claritin, Allegra and Zyrtec – do not have these side effects. “If people need to take antihistamines, there is no reason they should not be taking a nonsedating version, such as Claritin, which is now available OTC, or Allegra, which is available by prescription,” suggests John Weiler, M.D., professor emeritus at the University of Iowa.

3. Create an environment where employees don’t feel threatened to report to their supervisors when they are impaired due to the use of OTC medications. “The supervisor should then find another job for them to do that day that is less dangerous,” suggests Stebbins. This is better than telling the employee not to report to work in the first place, or sending the employee home if he or she has already arrived at work. Doing either of these will discourage the employee from ever reporting impairment again.

4. Supervisors should be trained to look for signs of impairment, such as lack of concentration, lethargy, agitation or other behavior the employee doesn’t commonly display.

5. Address issues related to long-term impairment. “You don’t want to allow employees to abuse your flexibility,” cautions Stebbins. For example, if an employee comes in to work two or more times a week claiming to be impaired because of OTC medications, you can’t always be expected to find alternate work for that employee. In this situation, Stebbins recommends trying to find another permanent position for the employee – one where safety will not be an issue. “It is important to reassign this person to a different job where their safety and the safety of others won’t be compromised,” she emphasizes. She recommends getting the employee’s physician involved, too, to discuss the employee’s capabilities and limitations.