Opioid Addiction in the Workplace

How HR Professionals Can Help Combat Addictions

A new survey by The Hartford found 65 percent of HR professionals recognize the opioid crisis is affecting their business, but the majority have not been trained on how to deal with addiction in the workplace.

More than 2 million Americans had an opioid use disorder in 2016 and 2017, costing employers billions in health care costs, not to mention lost productivity due to absence and decreased “presenteeism.” Rather than relying on government fixes, forward-thinking employers have realized the cavalry is not coming from Washington; to get a real handle on the opioid crisis, we must look beyond legislation. By providing high-quality, value-based primary care that is focused on long-term, positive patient outcomes instead of immediate, “quick fix” care, employers can help turn off the spigot that is flooding our system with new opioid prescriptions, overdoses and death, stopping addiction before it starts. One forward-thinking employer, Rosen Hotels & Resorts, found an additional dividend from their investment in value-based primary care—their opioid prescription levels are at one-sixth the level of typical employers. This, despite having a workforce with physically demanding jobs.

Opioid Addiction in the Workplace

By shifting away from today’s fee-for-service model—where physicians are incentivized to order more procedures and spend two hours on paperwork for every one hour they spend with a patient—and towards value-based primary care, employers could see less drug abuse and therefore fewer financial losses. A value-based care model encourages physicians to spend more time with patients to get a better look at not just why they are visiting, but what is causing them to visit. With less insurance bureaucracy, physicians can help patients identify and treat the root cause of their afflictions rather than adhere to the status quo’s pressure to prescribe, refer and move on to the next one.

In the current system, physicians hoping to keep patients satisfied prescribe painkillers like hydrocodone, oxycodone, morphine or benzodiazepines, often in excess—a JAMA Surgery study found that of the 30 pills they were given, most only took nine. This is particularly concerning given that 21-29 percent of people with chronic pain misuse the opioids they are prescribed, and that, according to RAND Corp. and a Harvard Medical School team, a third of doctors didn’t list a reason for why an opioid was prescribed. The most common reason for an opioid prescription is lower back pain, despite there being no evidence that opioids are
effective at treating lower back pain.

Employers will also see savings by shifting to a model that does not order unnecessary tests, and which offers shorter patient wait times and same-day appointments. Instead of waiting an average of 24 days to get an appointment with a doctor, many employees make an expensive trip to Urgent Care or the ER—only 43 percent of millennials say they would go to a primary care doctor for non- emergency care. Making the primary care process easier and more efficient will not only encourage employees to visit, but also help physicians catch serious health issues early, before patients need multiple (and costly) tests/procedures or drug intervention.

Fighting Opioid Addiction in the Workplace

Once there is a solid plan in place, be sure to educate employees so they know what is available to them. With 44 percent of people not feeling confident to make benefits-related decisions, according to a study by Lincoln Financial Group, education is going to be vital.

Presentations, workshops and even webinars can help address this, as would making sure that employees have print and online plan materials to refer to. HR professionals should also know how to appropriately answer employees’ questions. Thorough training will ensure the plan works as it should, and prevent people from frantically calling HR with coverage concerns.

It’s also important for HR professionals to know the signs of opioid abuse—taking pills longer than prescribed; developing a tolerance and increasing dosage; withdrawal symptoms including moodiness, nausea, vomiting, fever and muscle aches; etc.—and signs of an overdose: small pupils; difficulty staying conscious; shallow breath; gurgling/choking; limpness; and skin that is cold, pale or blue.

Surgeon General Jerome Adams believes it is essential for employees to know this information as well, and supports them learning how to administer the overdose- reversing drug naloxone. Some states even offer training and don’t require naloxone prescriptions. Being knowledgeable about counseling programs could help HR professionals, too. But why focus on responding to the issue at hand when employers can instead prevent it from happening by providing access to value- based primary care?

The low-quality health benefits employers offer, sometimes without question, have certainly contributed to the opioid crisis. HR pros can help those enslaved by opioid use disorders, but a series of small changes leading to a value-based care model can help prevent inappropriate opioid prescribing altogether. Employers: high-quality care and real change starts with you.