What employers should know about substance use disorders

Substance use disorder, the repeated misuse or abuse of substances such as alcohol or opioids, is a chronic, treatable disease that’s often mischaracterized as an individual’s moral failing. That, in part, has meant that many people who could benefit from the help a health care provider can offer can’t, don’t or won’t access it. This poses material problems for employers.

“Substance use disorders can create significant issues in both home and work settings,” says Melissa Perry, MD, Medical Director at Highmark Blue Cross Blue Shield. “In the workplace, it can affect performance, workplace accidents and injuries, more absences or leaves, can lower the morale in the workplace, and can lead to more conflicts with coworkers and supervisors.”

Fortunately, educated employers can play an important role in addressing this disorder.

Smart Business spoke with Perry about the impacts of substance use disorders and steps being taken to combat them.

Why are substance use disorders concerning?

Substance use disorders are characterized by unhealthy patterns of symptoms or behaviors related to the use of a substance such as alcohol or opioids. There is a broad range of symptoms and severity, and the disorder can co-occur with other mental health illnesses, such as depression and anxiety — the substances are often used as an unhealthy way to cope with the symptoms of those conditions.

Opioid use disorder is particularly concerning because opioids are dangerous for physical and mental health, have significant withdrawal symptoms, and have led to many deaths. For those who are in chronic pain that is not being addressed through medical treatment, the concern is that some turn to illicit substances or misuse another person’s opioid-based pharmaceuticals without provider oversight as they self-treat.

Over the past decade, there have been increased rates of substance use disorders. During the COVID-19 pandemic, there was a marked increase in substance use disorders as people were more isolated, experienced more mental health issues, and had less access to treatment and other healthy coping mechanisms such as going to the gym, going to church, or meeting with family or friends. There has also been an increase in overdoses and deaths, especially for those misusing opioids.

What steps are being taken to combat this?

One of the more critical steps is awareness. That often means more patient and provider education, which leads to more appropriate care, greater harm reduction, and safer storage and disposal of controlled substances. Greater access to treatment is still a work in progress, and tools such as telehealth are helping in that regard. There have also been legislative and administrative steps taken by governments to combat substance use disorders.

Another aspect of addressing the rise of substance use disorders is to reduce stigma. Substance use disorders can affect anyone regardless of gender, age, race, income or location.

What can employers do to address substance use disorders in the workplace?

Employers can provide awareness as well as access to employee assistance programs that can help identify concerns. They can look to decrease workplace stress and promote supportive recovery programs that can help prevent misuse. Employers also can help reduce stigma and encourage recovery through a supportive workplace, which could help lessen relapse.

Employer-sponsored health plans can help reduce stigma and provide screening measures for early identification, mitigation and treatment of substance use disorders at earlier stages. Having access to early treatment is extremely important. This is where telemedicine and telehealth have provided some improvements in access to care, making it easier to set appointments with an appropriate treatment provider.

Employers looking to help an employee they suspect is dealing with a substance use disorder should, before intervening, strive to avoid conflicts and worsening the stressors. They should also avoid approaching the issue with the mindset that substance use disorder is a choice and avoid creating any barriers to accessing treatment. ●

INSIGHTS Health Care is brought to you by Highmark Blue Cross Blue Shield

Melissa Perry, MD

Medical Director
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