This article is featured in the magazine, A Public Health Perspective on the Opioid Crisis. Download it now.
By Nicole Hare-Everline, Faculty Member, Public Health, American Public University
The opioid epidemic has major social implications with skyrocketing addiction rates and overdose deaths devastating individual lives, families, and entire communities. But what’s often overlooked is the damage the opioid epidemic has on businesses, as well as the role employers can play in helping to address—and stem—opioid addiction among their employees.
Opioid problems often begin when a legal drug is prescribed by licensed professionals for pain relief following an injury or surgery. Prescription drugs that are highly associated with addiction include pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others. After prescribing such drugs, many doctors do not provide patients with adequate information about potential addiction issues. As a result, rates of addiction to these pain relievers have risen dramatically.
It is estimated that at least 40 percent of opioid addicts are covered by employer group health plans, costing companies significantly through lost employee productivity, absenteeism, disability costs, workers ’ compensation claims, and overall medical expenses. Since the majority of employers provide group health plan options for their employees, they have a major stake in taking steps to combat opioid abuse.
The Society for Human Resource Management (SHRM) has outlined several methods employers can use to mitigate the risk associated with employee opioid usage and addiction. These methods include making impactful health plan design changes, implementing organizational policies surrounding substance abuse, and enhancing employee wellness and employee assistance programs (EAP).
Changes to Healthcare Plan Designs
Companies need to actively work with their health insurance providers to create a healthcare plans that help employees avoid getting addicted to opioids or, if an employee is suffering from addiction, to provide services to help them recover.
Limit Coverage of Opioid Prescriptions
Some organizations have reduced or limited coverage of opioids and made them only accessible through a specific network of pharmacies and/or providers. These plan revisions limit opioid prescription fills to three days or 10-pills, rather than filling prescriptions for 30 or more days, as was often done in the past.
Make Addiction Services Readily Available
For individuals who may already struggle with an opioid addiction, organizations can update their healthcare plans to remove the requirement for prior authorization for anti-addiction medication. This can ensure patients have access to addiction treatment options more readily and easily.
Another key strategy of employers has been to promote successful, best-practice treatment programs called “Centers of Excellence.” These specified treatment programs provide cost-effective, and high-quality treatment, which helps minimize escalating health care costs (i.e. healthcare premiums, provider visits, etc.) for both the employee and employer.
Expand Coverage for Alternative Pain Management Approaches
Additionally, companies can expand their health plans to cover alternative treatment methods for pain management. Expanding coverage for physical therapy, acupuncture, occupational therapy, and chiropractic treatment can enable employees to find new ways of managing their pain that doesn’t involve taking potentially addictive medications.
With the growing need for convenience, telemedicine provides in-the-moment solutions for health plans. Telemedicine allows healthcare practitioners and patients to utilize two-way communication such as video conferencing, phone calls, or email messaging. Many organizations have added this feature to their health plan provisions to ensure employees are not frequenting the emergency room as their medical home. Telemedicine allows the opportunity to steer medical encounters to the appropriate level of care. For example, an employee calling about addiction concerns can be directed to an appropriate specialist, such as a behaviorist, to address their questions.
Update Employee Handbook on Drug Use
In addition to health plan design changes, organizations must undergo an internal policy review and make revisions to their employee handbook to reinforce the organization’s stance on opioid use. Many employers have a no-tolerance stance on drug and alcohol use and should ensure they have a clear organizational policy.
Most companies publish a comprehensive drug and alcohol policy that, at a minimum, prohibits the use, possession, sale, distribution, or manufacture of drugs and drug paraphernalia at work. This document also often forbids employees from reporting to work under the influence, reserves the right to conduct searches of workplaces upon reasonable suspicion, and ensures compliance with applicable federal and state laws. Organizational policy should be well-planned and clearly written. Key staff should also be trained on the importance of the policy as well as how to implement and enforce it.
Improving Wellness Programs and EAPs
Employee wellness programs and employee assistance programs (EAP) serve as the organizational compliance gatekeepers and advocates for the enforcement for the organization’s alcohol and drug policy. EAP teams are instrumental in training supervisors to recognize signs of substance abuse and take appropriate action in accordance with company policy. Training should include:
- Ensuring that supervisors understand their specific responsibilities in carrying out drug-free workplace policies and know the reasons such policies exist
- Recognizing potential problems and signs of substance abuse
- Understanding proper protocol for documenting any problems
- Knowing methods to constructively address the problem including where, how, and when to refer employees who may be experiencing an addiction issue
In addition to the training, companies should provide a confidential phone number or website where supervisors can contact licensed EAP counselors who can provide support and guidance. This access should be made available every day of the week; 24 hours a day. Having such access allows the supervisor to verify they’re following company policy and proper protocol before addressing the issue with the employee. It also provides reassurance and insight about how to best approach an employee and assistance on determining if the situation is too volatile to address alone or in the workplace.
In addition to building staff awareness of alcohol and drug policies, employee wellness and EAP programs bridge gaps in addressing the opioid crisis through psychosocial interventions. For example, these programs can promote alternatives to pain management medications by offering onsite physical activity programs such as yoga, stretching classes, or other low-impact exercise programs. In addition, these programs can promote recovery options at the workplace such as peer-support programs, confidential counseling, and local resources like recovery groups.
National Prescription Drug Takeback Day is also an essential awareness platform for organizations. It offers employee wellness and EAP programs an opportunity to offer a safe, convenient means of disposing of prescription drugs. Moreover, it serves as an education platform about the potential for abuse of medications. This national health observation day happens twice a year, in April and October, allowing organizations to capitalize on the benefits of the program and educational awareness opportunities.
Organizations are being affected by the opioid crisis, but by taking some proactive measures, they can help educate employees about the dangers of opioids, discourage them from taking them, and, if addiction issues arise, have proper training and programs in place to get them help immediately.
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About the Author: Dr. Nicole Hare-Everline is a faculty member at American Public University teaching courses in the Public Health program. She is a public health and wellness expert with a health and welfare background. She is a dynamic and creative organizational leader with doctoral-level training and human resource background and more than 15 years of experience developing, implementing, and marketing benefits programs to multicultural populations. Nicole is a dedicated, innovative, and accomplished professional with proven talents in benefits and health program planning and development, promotion, program implementation and evaluation, funding development, managing budget, operations, and staff. She holds a bachelor’s degree and a master’s degree from the University of Central Arkansas and a doctoral degree in health sciences from Nova Southeastern University. To reach the author, email IPSauthor@apus.edu. For more articles featuring insight from industry experts, subscribe to In Public Safety’s bi-monthly newsletter.