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According to the CDC, 115 people die daily in the US of opioid overdoses. That’s more than from car accidents, gun violence, and most forms of cancer. Opiate-related overdoses are now the leading cause of death in Americans under the age of 50.
Though it seems we’re confronted with news about the opioid crisis wherever we turn, the situation isn’t getting any better. In the past year, ER visits for opioid overdose nationally rose by nearly 30%. How does this mounting crisis impact your business and what should you do about it? “…the combination of lower productivity, higher healthcare and substance abuse treatment costs, missed work and other opioid-related issues add up to $78.5B….”
The first step in solving a problem is admitting you have one, and here businesses may be missing the boat. In a National Safety Council survey, 39% of employers viewed prescription drug use as a threat to safety, and just 24% said it is a problem, even though seven in 10 companies reported issues ranging from absenteeism to overdose. In fact, the combination of lower productivity, higher healthcare and substance abuse treatment costs, missed work and other opioid-related issues add up to $78.5B, according to the National Center For Injury Prevention and Control.
The situation has gotten so bad for businesses that the Federal Reserve found that employers were finding it difficult to fill open positions, partially due to a skills gap but also because many applicants couldn’t pass a drug test.
There are steps you should be taking at your business to address this crisis. Nick Otto’s article, Opioid Treatment Costing Employers Big identifies three responsibilities that businesses have according to Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions
- Educate employees about opioid misuse – Currently, only 24% of companies provide training and education to employees in opioid use according to a recent National Safety Council survey. When it comes to educating employees, Thompson says issues to consider include proper storage and disposal of prescription medications, the dangers associated with sharing opioid medication with others, the need to ask questions of their providers if prescribed opioids as well as clarifying a clear path for how employees or their families can seek help and treatment if they are concerned about addiction or dependency.
- Employers need to review their programs and policies to better align with the collective opioid agenda. “Programs and policies are being relooked at to ensure appropriate coverage and support, while better defining expectations for both supervisors and employees,” Thompson says. “Employers should set expectations for EAPs, health plans and prescription drug managers to play a more systematic role to identify potential opioid misuse and take actions to help address systemic issues and support employees and their families who have opioid issues.”
- Engage with your health plans and PBMs to ensure they do their part. Employers are demanding and now getting more data from their health plan or data warehouse vendor and diving deeper to understand the impact of drugs on their population. Because of this, employers and PBMs are beginning to make progress to reduce the risk of overdose. They’re reducing barriers to medication assisted treatment and limiting the opioid dosage prescribed to individuals. A recent benchmarking survey last year from the Midwest Business Group on Health found most employers indicating that they are changing their pharmacy benefit design by putting restrictions on opioid prescriptions, using prior authorization and quantity limits (as low as a 5-day supply) and more advanced utilization management rules, notes Cheryl Larson, president and CEO of MBGH.
- Another step gaining proponents is the use of a segmented and data analytics approach to opioid abuse. Products such as Espyr’s Spotlight™ use data analytics to provide insights that enable managers to identify potential problems proactively. For example, Spotlight could identify the co-existence of conditions closely associated with opioid abuse and act as an early warning system for a potential problem.
Last, your EAP should be an active partner to you in your efforts. David Pawlowski in his recent article, Opioid-use disorders: The role of the employee assistance program points out the vital role that EAPs can play if their programs are built and positioned correctly.
1) Position the EAP as the entry-point for all mental health and substance abuse services. Employees with an opioid-abuse problem require a significant level of advocacy and support. Consider putting the phone number for the EAP on the company insurance card, with language that steers all employees seeking help for a mental health or substance abuse problem to the EAP first. Similarly, ensure that customer service representatives, benefits specialists and any other internal or external health plan experts or advocates are trained to refer employees to the EAP for assistance. The EAP should spearhead and deliver this external training initiative.
2) Ensure all calls into the program are answered live 24/7/365 by a licensed, experienced clinician. When an employee with an opioid-abuse problem calls the EAP, the first person he or she speaks with must be an expert. With opioid abuse, problems escalate quickly and crises are common. In most cases, the window of opportunity when an opioid user is receptive to help is short. An experienced clinician can reinforce the positive steps an employee is taking and use evidence-based strategies to enhance motivation to change and increase the likelihood that the employee will follow through with treatment.
3) Confirm that the EAP conducts a comprehensive mental health and substance abuse assessment for every participant. Stigma is real, and employees often minimize their problems. A comprehensive clinical assessment that includes evidence-based screening tools will ensure that no underlying issues are missed. Then, based on the assessment, the EAP clinician can work collaboratively with the employee to develop the most clinically appropriate care path – and provide guidance to the highest-quality and most cost-effective, in-network treatment options. By ensuring employees always receive referrals to the ‘right’ providers and facilities the EAP can have significant and measurable impact on healthcare costs.
4) Ensure that your EAP has a clinical orientation and can provide a warm hand-off to your medical plan. Opioid abuse or addiction will likely require longer-term and more highly structured treatment plans than typical EAP problem resolution. That means using resources within the employee’s medical plan. A variety of treatment options are available to battle opioid abuse, including detoxification, inpatient rehabilitation, outpatient behavioral health counseling and medication assisted treatment. Often, the most effective solution is a combination of multiple treatment types. By ensuring a secure, warm hand-off from the EAP, the employee’s case continues to be handled appropriately from start to finish. When addressing opioid addiction, the importance of ongoing case management at every stage of the treatment process cannot be overstated.
Your EAP can also be an organizational resource to assist employers who wish to take a more proactive role in addressing issues related to employee opioid use and abuse. The following are just a few of the many ways that an EAP can support the organization:
- HR/management consultation
- Drug-free workplace policy development
- Employee and supervisor education and training (including ‘reasonable suspicion’ training)
- Formal management referral services
- Substance abuse professional services (for employees whose job duties fall under federal Department of Transportation regulations)
The opioid problem is large and not showing signs of receding. Don’t assume your business or your employees are immune. They’re not. You may not be able to fix the problem, but taking the steps noted here will help you manage it and lessen it’s impact on your business.
To learn more about Spotlight or Espyr’s innovative EAP call 866-570-3479 or click here.