Why all employers need to be thinking about the opioid crisis

There’s almost no doubt that you’ve read or heard about the opioid crisis in the U.S. But did you know that employers can play a critical role in advancing solutions, education and treatment? A 2017 survey showed that affected employees are more likely to undergo treatment if it is initiated by an employer. Understanding the risks of the growing opioid problem and creating workplace environments designed to advance prevention, anticipate issues and support treatment can have a life-saving, tangible impact.

Workplace intervention strategies are particularly important given the scope of the issue at hand. Recently released data from the U.S. Centers for Disease Control and Prevention found that drug overdoses were the cause of  more than 70,000 American deaths in 2017— higher than those from HIV, car crashes or gun violence in their peak years. Since 1990, this number has increased by a staggering 650 percent. And for the third year in a row, the U.S. life expectancy decreased. This phenomenon has not been seen since World War II, and is largely believed to be driven by the rise in drug overdose deaths, of which at least two-thirds were linked to opioids.

Impact on the workforce

In 2017, the highest rates of opioid overdose deaths were among those 25–54 years of age, an age range that also corresponds with the bulk of an individual's working years. Labor force participation has fallen more in U.S. counties where relatively more opioid pain medication is prescribed. Estimates suggest that the opioid crisis will have cost over $1 trillion from 2001-2017, with an additional $500 billion between 2018-2020, of which productivity losses make some of the greatest impact.

As the opioid crisis progresses, direct impacts in the workplace are emerging with greater frequency. Overdose deaths at work from non-medical use of drugs or alcohol increased by at least 38% annually between 2013 and 2016. Survey results show that seven in ten employers report having been affected by employee use of prescription drugs, with almost 50% having experienced absenteeism or impaired worker performance and 26% having experienced a “near miss” or actual injury,overdose or arrest due to prescription drug use. 

Employees struggling with substance use experience around 50% more days of work lost compared to their peers, and healthcare costs for employees who misuse or abuse prescription drugs are three times the costs for an average employee, further underscoring the need for employers to take action for the health of their workforce and their business. The impact ripples beyond the individual employee who is struggling with substance use— 30% of employers report that employees missed work due to a family member’s addiction, in addition to showing signs of increased distraction and stress.

 Steps employers can take to respond

There is an immediate need and hopeful opportunity for employers to intervene in this pressing public health problem, yet a gap continues to persist between employer perception of the opioid crisis and the actual human and business cost. At IWBI, we recognize WELL projects that show leadership in addressing the opioid crisis using a range of strategies outlined in the WELL v2 ™ Pilot Mind concept. Here are some key steps to take that can help make a significant difference.

1) Evaluate your workplace.

It is essential that employers take pause to determine if their workplace is at higher risk. Specific industries are particularly vulnerable to opioid-related concerns, such as construction, extraction, food service, healthcare practitioners, entertainment and recreation. There are a variety of reasons why these workplaces disproportionately carry an opioid-related burden. Workplaces that operate under hazardous conditions may lead to employee injury from slipping, tripping or falling, and such injuries can become an employee’s introduction to prescription opioids. Other workplaces that require heavy-lifting or repetitive motion as a part of the job may result in chronic pain that is then treated with opioids.

High-stress work environments, including conditions like a lack of job security, lower availability of paid sick leave or lack of control coupled with high demands also place employees at risk for prescription opioid misuse. Additionally, workplaces that are accessible to the public, such as libraries, restaurants and parks, as well as buildings with public bathrooms or lobbies, may be at risk to have visitors who overdose while onsite.

WELL projects are encouraged to evaluate their workplace mental health needs through Mind feature M01 (Mental Health Promotion), which requires the provision of education, programming and initiatives tailored to the needs of the project. By using local or national data, research and trends, projects can evaluate whether their employees or visitors are at risk for opioid-related concerns.

2) Review your benefits offerings.

Employers can create a supportive environment simply by offering sufficient treatment coverage of issues that lead to opioid use, such as injury and pain, as well as coverage for opioid use disorder treatment. 

Health benefits for pain management should consider the inclusion of non-pharmacological treatments, like cognitive behavioral or exercise therapy, as well as non-opioid pain medications which can be used instead of opioid prescriptions in certain cases. Additionally, employees struggling with opioid misuse and abuse can be supported through employee assistance plans and other benefits offerings that cover evidence-based treatment programs, as outlined in Mind feature M14, Part 2 (Provide Access to Substance Use Services).

3) Engage in education & awareness efforts.

Provide employees with education regarding opioid use and its related issues, such as injury and pain. The Mind concept encourages projects to educate employees on substance use, including prescription opioids in M01, Part 2 (Promote Mental Health Literacy) and M14, Part 1 (Promote Substance Abuse Prevention and Education). Education not only helps employees make informed decisions, but it also provides an opportunity to reduce the costs companies face as a result of undiagnosed and untreated substance abuse.

4) Prepare for emergency situations.

At-risk organizations should be prepared for the possibility of an overdose on-site. Mind feature M15 (Opioid Emergency Response Plan), provides a framework to support organizations in efficiently responding to an opioid-related emergency. The incorporation of naloxone, a drug that has the ability to reverse an opioid overdose, into an organization’s first aid kit can be a life-saving resource in the case of overdose emergencies. In order for this strategy to be effective, an organization’s staff must be trained to recognize the signs and symptoms of an overdose as well as how to administer naloxone.

Hopeful directions

With preparation and action, employers and employees can help usher in a more positive future. And as is the case with many health interventions at work, treatment can also serve as a cost saving measure. Successfully getting an employee into treatment can save an employer up to $2,607 per team member annually, further underscoring the value of investment in employee treatment and support services.

The opioid crisis has reached a scale that necessitates a collective and united effort. By supporting prevention, treatment and recovery efforts, workplaces of all sizes can make a meaningful difference for their employees, the local community and society at large.