From Legal to Fatal: How Opioids Became an Epidemic and How Employers Can Respond
The opioid problem has reached epidemic proportions, affecting 40% of Americans in some way and costing businesses $26 billion to $54 billion per year in lost productivity. The best way for employers to combat the problem is through a holistic response including robust return-to-work programs, effective management and solid company policies.
Those were some of the major revelations from a June 20 webinar by the Disability Management Employer Coalition, featuring Lincoln Financial Group’s scientific adviser Dr. Glenn Pransky and AVP of the Absence & Statutory Group Product Solutions Kim Rudeen.
During the webinar, Pransky and Rudeen laid out some sobering statistics:
- Drug overdoses (52,404 in 2015) kill more people than automobile crashes (38,022) and gun homicides (12,979) combined.
- 21% to 29 % of chronic opioid users take more medication than prescribed.
- 8% to 12% of prescription opioid users develop opioid use disorder (OUD).
- 10% of people with OUD transition to IV heroin use — accounting for eight out of 10 new heroin users.
How We Got Here
The problem began after the Civil War when injured soldiers became addicted to opium. Years later, Bayer sold heroin as a safe, long-acting method of pain control. The nation responded with the Harrison Narcotics Act, a 1914 law limiting the production and distribution of opiates.
“We seem to have forgotten these lessons again,” said Pransky, detailing how a letter published in the New England Journal of Medicine — stating that some patients on long-term opioids for chronic pain didn’t show signs of addiction — opened the floodgates for today’s opioid epidemic.
“Purdue Pharma grabbed hold of this data and said ‘here’s an opportunity to market our long-acting pain medications as safe and useful for any pain’ — and that was really the genesis of the current opioid epidemic,” said Pransky.
“Within 10 years of this marketing effort, the FDA assessed Purdue Pharma a record fine for deceptive marketing of an unsafe product. But by then the opioid epidemic was already launched.”
Action Items Any Employers Can Take
The opioid problem has, of course, had devastating effects on the American workplace — with plenty of injured workers falling victim to addiction and workers’ comp programs in need major overhauls. The first step an employer should take is developing a sound policy around opioid and drug addiction. Rudeen said that begins by company leaders asking themselves a series of questions, including:
- How do my health policies and coverages feed into this problem?
- How can I structure those benefits so they’ll promote alternative therapies — or create a route that’s not so direct for accessing opioids?
- Am I covering the right levels of treatment for people when they have an opioid problem? Am I making it easy for employees with a problem to come forward?
- What educational resources do I provide around addiction and return-to-work?
- If a manager thinks an employee has a problem — what steps should they take?
When that policy is in place, make sure managers know exactly what their roles are when spotting an employee who may have a problem and supporting them through treatment.
“We don’t think supervisors should have in-depth conversations with employees. We don’t want them talking about medical conditions, medications and why they’re taking them,” said Rudeen who suggests saving that conversation for an Employee Assistance Program or human resources.
But managers should be trained on warning signs — like an employee who is consistently late to work or having more accidents than usual. Approaching that employee takes a delicate balance.
“It needs to be very fact-based, and non-judgemental. That requires a lot of training,” said Rudeen.
While an employee is going through treatment, it’s important that supervisors show support. “It’s critical that a supervisor can help that employee feel important, valued and understood as they’re struggling through the process,” she said.
In many cases, the stigma attached to opioid addiction can be just as debilitating. Employees with opioid problems might keep the problem secret rather than telling managers and facing possible disciplinary action.
“They won’t even research what types of benefits they have for fear that someone can monitor what website they went to or who they called from the healthplan,” said Rudeen.
They’ll end up using private pay for a fancy rehab facility instead of using their health benefits for treatment in their own communities — which Rudeen says is much more effective because it “teaches them to deal with day-to-day like stressors and challenges they would not normally face when on the other side of the country laying on a sunny beach.”
Plus, rehab facilities are expensive, eat up personal time off, and don’t offer the employer insight into your problem.
“When they come back to work, nobody knows they have challenges,” said Rudeen. “That’s why we want employers to be comfortable talking about this issue, educating employees, letting them know you’re here to help because that’s going to make it easier for them to open the door and have those conversations with you.” &