September is National Recovery Month and a good time to start
In-touch employers know that the effects of the opioid crisis are felt far beyond employees’ homes. Those struggling with substance use disorder are mothers, fathers, friends, daughters and sons. And, 70 percent of them are also employees. As the crisis has worsened over the past few years with deaths due to synthetic opioid overdose skyrocketing and ER visits for all types of overdoses increasing, so has the impact on employers around the country, specifically in certain areas of the country that are hardest hit.
Source: The Henry J. Kaiser Family Foundation. (2019). Opioid Overdose Death Rates and All Drug Overdose Death Rates per 100,000 Population (Age-Adjusted): 2017. Retrieved April 19, 2019 from: www.kff.org/other/state-indicator/opioid-overdose-death-rates/.
Opioid use disorder takes an emotional, physical and financial toll that can be felt in the workplace. We know that about 90 percent of those who are suffering don’t get help. It’s common for those with opioid use disorder to also have a behavioral health condition. All of these, especially when untreated, have a financial impact to the employer. When treated, for every dollar put into treatment, there is a return of $4 in improved health and productivity, according to the World Health Organization.
Source: Anthem commercial data
National Recovery Month, celebrated in September, is a fitting time to develop a plan to address substance use disorder in the workplace. Employers can help in reducing the stigma for those with substance use disorders, in addition to actually guiding them to recovery.
First, employers should know potential signs of opioid misuse symptoms, which include:
- Change in workplace attendance as people who misused opioids account for 65 percent of medically related absenteeism.
- Increased time to complete tasks
- Increased accidents on the job
- Extreme emotional changes
- Incomplete work and/or missing deadlines
- Change in personal appearance and hygiene
Here are some direct actions employers can take:
- Raise awareness and address stigmas through direct to employee communications
- Consider implementing a prescription drug use policy in your organization
- Encourage employees to use an Employee Assistance Program
- Encourage employees to contact their medical benefits for help options
- Educate employees about the safe use of opioids, and how to talk to their physician
- Educate employees on proper use and disposal of prescription medications
The following resources may be helpful in employers in taking a more active role:
- The National Safety Council offers a free toolkit on substance abuse in the workplace.
- The Substance Abuse and Mental Health Services Administration also offers free toolkits on how to implement programs to encourage a drug free workplace.
- The Kentuckiana Health Collaborative offers its free toolkit as well.
Health plans also can also make a difference both in prevention, treatment and recovery and deterrence. Employers should ask what actions their health plans are taking to make a difference in the epidemic. To see Anthem’s full response to the opioid crisis, you can view a white paper released by the Anthem Public Policy Institute.
The first step Anthem took was to make sure that our health plans were covering opioid prescriptions consistent with CDC prescribing guidelines to help ensure clinically appropriate “new starts” or opioid prescriptions – with exceptions for chronic pain and terminal illness. These changes included seven days’ supply limits on short-acting opioid prescriptions and prior authorization on long-acting prescriptions. Since 2015, the number of opioids dispensed to individuals enrolled in commercial and Medicaid plans has been reduced by 50 percent. Anthem also enrolls members at risk of addiction as measured by having multiple pharmacies or providers – in a pharmacy home program that brings oversight to just one pharmacy or provider.
At Anthem, we’ve encouraged primary care doctors and their care teams to screen more often for substance use disorder, and we’re happy to say this has resulted in a large uptick – 220 percent from 2015 to 2018 — in the number of screening claims we’ve received.
Treatment and recovery
When prevention hasn’t worked, it’s important for members to know they have treatment options. Most Anthem health plan members also have access to Employee Assistance Plans, which offer the first several counseling sessions for free.
To increase access to treatment, Anthem has made a commitment to counseling via telehealth, either outpatient treatment through LiveHealth Online Psychology or medication assisted therapy, or MAT, through Bright Heart Health. MAT provides opioid and medication assisted therapy – which consists of both talk and drug therapy – in four states. Anthem also has pledged to double the number of members receiving medication assisted therapy which we believe will result in longer term recovery with fewer relapses.
Anthem is part of several industry efforts underway – one led by Shatterproof and another by the Blue Cross Blue Shield Association – to objectively assess treatment centers and provide information to the general public about the centers’ results and whether they follow evidenced-based medicine.
Anthem also uses data to identify potentially abnormal prescribing patterns and misuse of opioids. This can flag potentially fraudulent prescription patterns. Anthem also closely tracks fraudulent practices associated with treatment in or referrals to substance use disorder rehabilitation providers.
***The toolkits referenced in this blog are provided for informational purposes only. The toolkits are provided by external entities and are not endorsed by Anthem.