Employers in areas with high rates of opioid abuse say employees’ use of prescription painkillers and heroin is taking a financial toll on their companies. Problems range from lower productivity to higher turnover, according to The Wall Street Journal.

Some employers in Allen County, Ohio say up to 70 percent of job applicants are failing drug tests, according to Jed Metzger, President of the Lima/Allen County Chamber of Commerce. Employees in the greater Cincinnati area, which includes parts of Ohio, Kentucky and Indiana, have tested positive for opioids after being involved in accidents, ranging from damaging property with heavy equipment to crashing company vehicles.

In addition to higher accident rates, employee opioid use can contribute to increased theft and absenteeism, says Trey Grayson, President of the Northern Kentucky Chamber of Commerce. Job performance can also suffer for employees who do not use opioids themselves, but have a family member who does, he notes. “All of these things bring real cost to employers,” Grayson said.

Between 2003 and 2013, overall drug use among U.S. workers declined 18 percent, but rose for certain opioids, including Dilaudid and Vicodin, according to Quest Diagnostics.

Companies are responding to employee opioid use by expanding drug testing, introducing zero-tolerance policies and adding employee-assistance programs for workers who need addiction treatment.

One company, ChemDesign of Marinette, Wisconsin, is bringing in law enforcement to train supervisors in how to spot signs of drug use. The company has joined with two other local businesses to start a program to teach workers about the dangers of opioids, and how to deal with a child who shows signs of addiction. The companies hope the program will discourage employees from thinking they can simply switch companies if they test positive for drug use at their current job.