Increasing media coverage and a growing body of epidemiological studies have raised awareness about the alarming rise in abuse, addiction, and deaths from both illicit and prescription opioids. In the US, deaths from opioid overdoses continue to rise, reaching more than 33,000 in 2015. One of the clearest changes in the new face of opioid abuse involves a major sociodemographic shift among users into the adult working population. More than 70% of employers in the US are feeling the direct impact of prescription drug misuse in their workplaces, and many are beginning to recognize that impaired workers are a serious concern for safety and liability. The mounting toll in lives, family suffering and workplace productivity which can be attributed to opioid use and related negative health consequences cannot be ignored, and employers can take steps to minimize their risk and help protect their workforce.