It’s a data point that should command our attention. The highest number of fatal drug overdoses ever recorded in the U.S. in a single year – 87,203 deaths in the 12-month period ending last September – is a grim hallmark of the pandemic. This represents a U.S. average increase of 28.8 percent. But there are other numbers that bear citing, and they relate to the encouraging news that employer investment in recovery saves lives and dollars.
Degrees of grim: COVID-19 makes a bad situation worse
While COVID-19 was filling hospital beds beyond capacity in 2020, data also show that emergency room visits for mental health issues, suicide attempts, drug overdoses, and violence between intimate partners all increased compared to 2019. The increases were not minor. Emergency room visits for drug overdose went up by 45 percent, even though overall emergency room visits dropped as people sought to minimize exposure to the virus.
But even before the COVID-19 pandemic wreaked havoc on lives, jobs and the economy, substance use disorders were rising fast enough to worry Janet Yellen, then chair of the Federal Reserve System. In testimony before Congress in 2017, Yellen made a connection between the opioid crisis and the declining number of people working or looking for work. “I do think it is related,” she said in answer to a question about labor force participation rates and substance use. She also noted opioid death rates were up, saying, “it’s obviously a very serious and heartbreaking problem.”
Employers are paying a high price for untreated substance use disorders – an additional $8,817 on average, every year for each employee with an untreated substance use disorder.
What’s work got to do with it?
The costs most directly associated with substance use disorders are workplace related: lost productivity, job turnover and retraining, and health care. Analysis from NORC at the University of Chicago indicates 70 percent of those struggling with substance use disorders are in the workforce. The same analysis shows that employers are paying a high price for untreated substance use disorders. Annual average additional costs to employers have risen 30 percent in just three years for every worker with an untreated substance use disorder. That translates into employers spending an additional $8,817 on average, every year for each employee with an untreated substance use disorder.
Conversely, substantial savings are realized when an employee is in recovery – to the tune of $8,500 on average per year, per employee. A worker in recovery misses fewer days at work, stays in his/her job longer, is less likely to be hospitalized, and has fewer primary care visits. Employer costs for insurance and medical care are lower for employees without a substance use disorder.
Seeing is believing – Employer cost calculator
Generalized data, percentages, facts and figures often don’t register in the same way as seeing the dollars and cents impact on an employer’s business. A newly revised tool from the National Safety Council offers a clear picture of costs associated with substance use disorders in the workplace. Rather than looking at data abstractly, the tool distills information from a variety of sources such as the National Survey on Drug Use and Health (NSDUH) into tailored, actionable intelligence.
The Substance Use Cost Calculator for Employers is simple to use. Input the state, number of employees, and select an industry. The calculator generates cost breakdowns for lost time, job turnover and retraining, and health care for a business specifically matching this profile. The report drills down to specifics such as how many days in the hospital, emergency room visits, and outpatient visits are projected to result from substance use disorders. Seeing the numbers associated with a workplace that could very well be their own makes a compelling case for employers to act. Right now, action is what’s needed.
Conversely, substantial savings are realized when an employee is in recovery – to the tune of $8,500 on average per year, per employee.
Treatment works – stigma does not
“What employers do can save lives,” said Tracy McPherson, a scientist in the Public Health department at NORC. One in 12 workers have an untreated substance use disorder, but for a variety of reasons, treatment lags far behind in reaching those who need it. Analysis from the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that little more than 10 percent of those who need treatment for substance use disorders actually get it. Medical professionals agree that substance use disorders involve a complex array of brain and behavioral elements, and that treatment can be equally complex. But what explains why so few get care?
The stigmatization of addiction as a personal failing rather than a disease is one long-standing obstacle that discourages treatment. There is shame associated with substance use as a sign of a weak or flawed character. And there are the very real fears of potentially losing a job, home, relationships – or even face jail time – due to a substance disorder. These are powerful negatives that often lead to denial rather than taking a step toward recovery.
Treatments initiated through employer-sponsored efforts are more likely to succeed than those initiated by family or friends.
According to NORC, treatments initiated through employer-sponsored efforts are more likely to succeed than those initiated by family or friends. Employer programs can be implemented across the entire organization, without singling out individuals. And there can be a spectrum of initiatives, ranging from making people more aware of their benefits, to wellness programming, to full-fledged treatment options. An environment that emphasizes empathy, understanding and support for recovery can counter the stigma.
Gateways to treatment
Mental health issues are often concurrently experienced with substance use disorders. Treatment for mental health is more readily accepted, and therefore can be an important gateway to reach those needing substance use disorder treatment. Wellness programming in the workplace can tap into an employee’s natural curiosity about how to cope with ordinary levels of mental stress, for example, and also be a catalyst that encourages those who need more professional help to get it.
While social isolation was encouraged to abate COVID-19 infections, it also made it easier to hide a substance use problem. And that very isolation often triggered emotions such as loneliness and sadness that can draw an individual to substances. Adapting to online and remote work was and continues to present challenges, but work offers some counterpoint to isolation. Workplace resources may be the most accessible lifeline providing a safe and confidential space to get help – in person or remotely.
Options for treatment range across a wide spectrum of services and amenities. The rehabilitation industry is poorly regulated, and even “accredited” programs may simply consist of a private company offering a review in exchange for a fee. Those desperate for treatment can easily fall prey to unscrupulous recovery programs that do a hard sell of their luxury amenities such as pools and gourmet meals, but offer little in the way of evidence-based care.
Employee assistance programs can help navigate this landscape, and at a minimum encourage someone seeking help to check with their primary care provider to get a reputable referral. Employers have a stake in getting the right care to restore a worker to his/her best potential. Devoting resources to do this offers the prospect of good outcomes for employers and workers alike.
The COVID-19 wake-up call: health and the economy are related
Janet Yellen, who now serves as head of the U.S. Treasury Department, clearly understood the negative dollars and cents repercussions of substance use disorders back in 2017. She also squarely put her analysis into a human context: lives are being devastated. COVID-19 has only accelerated the need to take heed of her prescient warning: a healthy economy needs healthy citizens.
The increase in drug overdose deaths and emergency room visits for mental health crises throughout the pandemic is our wake-up call. Let’s find the resolve to strengthen our friends, neighbors, and our nation. Harnessing the power of the workplace to put the pieces into place for health and well-being is ethically and financially sound.
What is a substance use disorder?
The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) defines substance use disorders (SUDs) as occurring when:
“recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.”
Substance Use Disorders describe both the use of illicit, or illegal, substances and the misuse of legal substances like alcohol, nicotine, or prescription drugs.