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Opioid crisis exacerbated by COVID-19: What employers can do

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The COVID-19 pandemic has forced states across to the country to continue measures such as social distancing and shelter-in-place to stop the spread of disease. The isolation and anxiety as a result of distance and the disease poses challenges and risks for the millions of Americans fighting another epidemic at home — opioids.

On average, 130 Americans die each day from an overdose involving opioids, many of whom started with a medication prescription to manage pain. With COVID-19, there are real concerns that progress made towards addressing this crisis is being lost as daily routines are uprooted, access to crucial support or care is disrupted, and concerns over finances and employment are impacted as the pandemic continues.

How does the opioid crisis impact employers?
The effects of the opioid epidemic reach extensively into the business community — 75% of employers reported being directly affected by opioids, often as contributing to workplace accidents, lost productivity, staffing issues, missed workdays, and increased care and leave costs. Recent research reveals that pain relievers were the most commonly misused prescription medication among the employed population with one in seven employees who used such medications showing problematic patterns of use.

Over all, one in three employees use prescribed pain medication. While most use the medication as directed, the concern is the addictive nature of these substances that can lead to misuse or use of more dangerous substances such as heroin or fentanyl when they can no longer obtain prescriptions.

Employees who took pain relievers — regardless of whether they used the medication as directed or showed signs of problematic use — were found to be absent from work more than twice as often as employees who did not use them. In terms of lost work time, this equates to at least a 1.25 extra lost workday per month than non-users. This is indicative of the cost associated with pain related conditions — people are taking time off because they must deal with a medical problem causing pain. But when problematic patterns of use come into play, employees are missing even more work than those who are taking their medications as directed.

What role can employers play?
Given the prevalence of prescription pain medication in use, it reflects a larger pain management issue within the business community. When people receive a prescription, they can develop problems, even though their medication use began under the care of doctors. Now compounded with ongoing COVID-19 stressors that could escalate risks of opioid misuse, it is vital that employers ensure their health programs include effective pain management approaches to provide the workforce with resources, support, and guidance needed. Consider the following:

  • Understand risk: Conduct confidential health risk assessments to identify risks among your workforce and prioritize resources for your workforce accordingly and collaborate with your group health carrier or pharmacy benefits manager to track overall spending and trends for opioids.
  • Raise awareness in the workforce: Invest in training to help employees and managers recognize the signs and symptoms of substance misuse as well as to destigmatize substance use and other related behavioral health problems. Promote resources to encourage employees to seek help when needed. Consider also consider publishing a formal drug-free workplace policy to let employees know what is expected and what happen when rules are violated.
  • Prevent abuse: It is important to help employees manage their pain so that their medication use does not become abuse. Strategies such as identifying injured employees with risk factors for pain use and responding immediately to workplace injuries would be beneficial. Coordinate a post-injury plan with the employee and use return-to work strategies such as graduated returns, flexible schedules which allow for treatment adherence, temporary job reassignment, and work accommodations. Also, work with your pharmacy benefits manager to ensure pain medications comply with opioid prescribing guidelines.
  • Ensure access to needed treatment: Approach substance use disorder as a chronic condition to help ensure patients access the evidence-based treatment resources they need.
  • Leverage partner’s expertise: Confirm that programs have direct clinical expertise with substance use disorders and chronic pain issues. Coordinate efforts with partner organizations to help ensure the success of efforts to maintain employees’ health and productivity through episodes of pain, psychological distress, or substance abuse.

As employers begin implementing their return to work strategies, it’s important that they remain focused on managing the opioid crisis considering the broader global health and economic crisis of COVID-19.

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