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Opioid Trends
An Overlooked Risk?
The 2012 National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), found the rate of binge drinking among people ages 65 and older was 8.2 percent, the rate of heavy drinking was 2 percent, and the rate of current illicit drug use among adults ages 50 to 64 has increased during the past decade.
“According to SAMHSA experts the baby boomer generation contains a higher percentage of illicit drugs users than any other age group because boomers were the first generation to participate in widespread use of a variety of recreational drugs, the first generation to have prescription medications readily available to them, and the last generation to grow up with a strong stigma against seeking substance abuse treatment,” said Kevin Glennon, vice president, clinical education and quality assurance, One Call Care Management.
Baby boomers’ formative years played out during a period of broad experimentation with and acceptance of illicit drugs.
Now they’re entering a phase of life where any children they have are likely grown and independent and retirement is on the horizon, which could translate to fewer responsibilities both at home and at work.
That freedom may make it easier for boomers to pick up old habits, only this time with prescription medications.
The national drug use survey estimates that the number of adults age 50 and older who will need alcohol or drug treatment will increase from 2.8 million in 2002-2006, to 5.7 million by 2020.
Currently, 4 million older adults need substance use treatment, including 0.4 million for illicit drugs, 3.2 million for alcohol, and 0.4 million needing treatment for both.
“Today, many boomers are turning to prescription opioids as their drug of choice. Baby boomers do not view this as an issue requiring intervention, and as such are extremely guarded when treatment options are discussed,” Glennon said.
Employers and workers’ comp payers should not overlook these factors if they have an older worker on prescribed painkillers for a work-related injury or illness.
“After a certain period of time the patient will begin to develop a resistance to [the opioid] and it stops controlling the pain effectively,” said Bill Spiers, vice president of risk control services, Lockton.
“Because the healing time is slower, just by nature of the effects of aging on the body — they regenerate tissues slower — it extends that period of time. So what ends up happening is the person — and this happens typically with soft tissue injuries — will experience slower pain improvement, and so the medical professional will look for solutions.”
Pharmacy benefit management is one go-to way to keep an eye out for red flags and monitor physician prescribing patterns, but employers can take a more proactive approach by setting up a workplace support system.
One factor that can contribute to an older worker’s propensity to abuse a substance is the psychological component. Some boomers certainly look forward to retirement with excitement, but others fear losing a sense of purpose or relevance. That disconnectedness lends itself to loneliness and depression, both of which can contribute to the development of an addiction.
“Today, many boomers are turning to prescription opioids as their drug of choice. Baby boomers do not view this as an issue requiring intervention, and as such are extremely guarded when treatment options are discussed,” — Kevin Glennon, vice president, clinical education and quality assurance, One Call Care Management
“There are two reasons why injured workers have problems with their claim; when they get injured, they’re either angry or afraid. And those cause workers to shut down and not want to get treatment or cooperate,” Spiers said. Lockton trains ‘injury counselors’ to work one-on-one with patients, providing the type of support that the workers might be lacking from their own social network.
“The injury counselor tries to develop a friendship so they stay in touch. Not everyone has strong family or social ties around them, so they need someone that follows up with them and stays on top of them,” Spiers said.
“Things like depression can exacerbate that claim, one technique that employers use to keep that person motivated to work though their pain is to keep them engaged in the workplace, which they do through close communication.”
Employers can also make extra efforts to keep injured workers — especially those nearing retirement age — engaged in activities both in and outside of the workplace through wellness initiatives. Encouraging exercise can help an injured worker grown stronger both physically and mentally, Spiers said.
Providing a support network and establishing a channel of communication may in fact be the best that employers can do, since a red flag isn’t raised on every case where a medication is abused.
“Addiction or abuse, regardless of the drug of choice is often very hard to detect,” Glennon said. “There are functional alcoholics that work and function with no signs of intoxication, the same holds true with prescription drug use or abuse.”
