The director of the Centers for Disease Control and Prevention (CDC) declared an opioid “epidemic” in the U.S. in 2011, and concern about this issue continues to grow. Employees that misuse or abuse prescription opioids are more likely to miss work, incur higher health care costs, file disability claims, and get demoted or fired. Sadly, more people died from drug overdoses in 2014 than in any year on record, and more than 60% of these deaths involved an opioid.
Employers can take several steps to stem the misuse of these drugs and provide assistance to employees and dependents in need of assistance to treat pain and addiction.
Help employees understand appropriate use of these powerful medications by promoting education resources like Consumer Reports’ 5 Surprising Facts on Prescription Painkillers; Avoid Opioids for Most Long-Term Pain; and Pain Relief: What You Need to Know.
Encourage alternative pain management, including lifestyle adjustments, behavioral therapy, exercise, acupuncture and massage. These strategies can help reduce pain without the risks associated with opioid medications. Consider reducing cost-sharing on these alternative pain management therapies for patients with a history of addiction or opioid abuse.
Step therapies should require documented pain evaluations and non-opioid and generic treatments before covering opioid and brand-name medication. Quantity limits reduce the likelihood that patients will abuse or overdose on the drugs. For example, Blue Cross Blue Shield of Massachusetts requires prior authorization for more than a 30-day supply of opioid medication within a two-month period.
As adverse events due to opioid addiction have risen, Medicaid and commercial health plans have begun to “lock in” individuals suspected of doctor-shopping by requiring them to use a single pharmacy and/or single prescriber for prescription opioids.
Patients who have stopped using their prescription opioids because their pain has subsided should dispose their unused medications properly to prevent children, pets or others from ingesting them. Many pharmacies have medication take-back programs. The FDA recommends contacting city and local governments that run waste management and law enforcement, as many of them have medication disposal programs as well.
Stress, mental illness, alcohol abuse and long-term post-surgical recovery can contribute to patients becoming dependent on prescription painkillers. Employers should encourage employees to take advantage of EAP and medical plan benefits that offer counseling, rehabilitation and/or screening from a professional provider who can help monitor the employee’s drug use and offer resources to help with their addiction.
Employers who want to learn more about this topic can join us at the 2017 Employers' Forum on Mental Health and Emotional Well-Being in San Francisco, California, January 25-26, 2017.