Mountain State Matters

The Charleston Gazette reported today that West Virginia is the third-most dangerous state in the nation to work in, trailing only Alaska and Wyoming in workplace death rates.

However, I’m not sure that mandatory drug testing would be the answer, as suggested today on Think Tank, the Official Blog of the WV Republican Club.

True, Kentucky now tests its coal miners. However, the issue of coal mining and painkillers isn’t an issue that can be resolved by testing and firing all miners who are found to have drugs in their system. Which came first, for the majority of coal miners: coal mining or painkillers? Coal mining.

An excellent in-depth article in The Washington Post last January by Nick Miroff chronicled the lives of Virginia miners like Jeff Trapp, who got prescribed Oxycontin because of mining accidents and ended up hooked.

With disability rates as high as 37 percent in coal-mining areas such as Buchanan County, the region has many people with long-term pain management needs. As is the case with lots of aging miners, Trapp’s addiction to pills began in a doctor’s office, not a back-alley drug deal.

“Busted-up” from 30 years working as a heavy-equipment operator and mechanic on the massive excavators used for strip mining and mountaintop removal, Trapp needed multiple surgeries to fix seven ruptured and herniated discs. Doctors wanted to implant a magnesium rod to stabilize his spine, but Trapp refused.

“I’ve known too many people who’ve done it, and they can’t tie their shoes,” he said.

So Trapp loaded up on painkillers, first Percocet and later OxyContin. When the prescribed dose no longer did the job, Trapp took more. Then more. He began “doctor shopping,” driving to Roanoke and Richmond to find physicians who would give him prescriptions.

When the pharmacies couldn’t provide enough pills, Trapp found dealers who would. Friends were melting oxycodone tablets and injecting themselves — “bangin’ OCs” — but Trapp was too squeamish to mess with needles. He crushed the tablets and snorted them like cocaine off his kitchen table. He didn’t feel high, just “good.” The relief was instant.

“I got hooked on those bad boys real bad,” he says.

The Pump Handle, a public health blog, responded to Nick Miroff’s article. Celeste Monforton (who works for the Project on Scientific Knowledge and Public Policy at George Washington University and used to work for OSHA and MSHA) commented that MSHA has focused heavily on the problems and hazards caused by miners who come to work under the influence of alcohol and drugs. However, all the stress was put on creating a “Drug Free” workplace.

I went back to the symposium’s summary report and was disappointed to find nothing—absolutely nothing—about preventing workplace injuries as a way to avoid (at least) some cases of substance abuse. Should a little bit of money for the “war on drugs” be redirected to a war on workplace injuries?