Reining in Opioids

Opioid Abusers Cost Employers $8 Billion Annually

A new report suggests that the prescription opioid crisis is getting worse, not better.
By: | May 9, 2016 • 3 min read

Opioid-abusing employees cost their employers up to $8 billion a year, according to a new study.

Castlight Health, a health benefits platform provider, found that companies paid nearly twice as much in health care expenses for opioid abusers than non-abusers — $19,450 compared to $10,853.

“Based on Castlight’s estimate, opioid abuse could be costing employers as much as $8 billion per year,” according to “The Opioid Crisis in America’s Workforce.”

“Considering that absenteeism and presenteeism tied to opioid misuse and abuse is costing employers an additional estimated $10 billion, this crisis represents a significant drain on America’s employers.”

“Many employees do not recognize the serious risk of addiction before they accept or fill an opioid prescription of any length.” — “The Opioid Crisis in America’s Workforce,” Castlight Health

Castlight examined nearly 1 million health care claims involving opioid prescriptions for the period 2011 to 2015 for workers at large, self-insured companies.

Leveraging Analytics and Education

Employers may save money by leveraging data and analytics to identify opportunities to help employees who abuse opioids.


“Whether it’s guiding an employee away from unnecessary back surgery (and the resulting opioid prescriptions) or offering programs that provide access to opioid abuse treatment, Castlight believes that data and analytics are part of the solution.

“For example, better insights can help a benefit leader identify where lower back pain or depression, two conditions closely associated with opioid abuse, are most prevalent in their company.”

Targeting educational content to such employees will help inform them of the dangers of opioids.

Individuals with a behavioral health diagnosis of any kind are three times more likely to abuse opioids than those without such a diagnosis.

“Many employees do not recognize the serious risk of addiction before they accept or fill an opioid prescription of any length,” the study said.

Abuse Factors

The report also identified some common themes about workers more likely to abuse opioid prescriptions.

• Individuals with a behavioral health diagnosis of any kind are three times more likely to abuse opioids than those without such a diagnosis, and nearly 9 percent of people with a single behavioral health diagnosis such as anxiety or depression were found to abuse opioids, compared to 3 percent of individuals without a behavioral health diagnosis.

“This finding is striking given the prevalence of behavioral health issues in the workforce,” the report said. “Twenty-five percent of employees have a diagnosable behavioral health condition; yet 70 percent of impacted employees go untreated.”

• Opioid abusers also have twice as many pain-related conditions as non-abusers, especially joint, neck and abdominal pain.

• Baby boomers are four times more likely to abuse opioids than millennials. More than 7 percent of workers age 50 and older were classified as opioid abusers, compared to 2 percent of those aged 20 to 34.

• States with medical marijuana laws are nearly twice as likely to have a lower opioid abuse rate than those that don’t, by a margin of 5.4 percent to 2.8 percent.

• Opioid abusers are more likely to live in the rural South and live in low-income areas.

• Opioid abuse rates range from 11.6 percent of individuals in Wilmington, N.C., to 7.5 percent of individuals in Fort Smith, Ark..

• Alabama, Florida, North Carolina, Oklahoma, North Carolina, Tennessee and Texas have multiple cities that are in the top 25 for opioid abuse rate. The three non-southern cities in the top 25 are: Terre Haute, Ind.; Elmira, N.Y.; and Jackson, Mich.

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]