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Kaiser Permanente: Opioids, Addiction and Creating a Recovery-Ready Workplace

Originally published on business.kaiserpermanente.org by Paul Bryant, LCSW, CADC III.

Most organizations are working to reduce stigma and empower employees to seek help for depression and anxiety. But just 20% of employers have done the same for addiction — even though 3 in 4 adults living with a substance use disorder are in the workforce.1,2 To fully support workforce health, businesses need to view addiction through the same lens as other mental and physical health conditions, and become recovery-ready.

An equal-opportunity destroyer

The human cost of the opioid crisis is well documented. And one of the most powerful takeaways is that addiction doesn’t discriminate. There are people from every age group, ethnicity, tax bracket, education level, and industry who struggle with it. The problem is bigger than opioids — the underlying issue is that addiction is a serious disease, but only 1 in 10 people who need treatment ever get it.3

Addiction and substance misuse take a massive toll on the economy — over $442 billion per year.4 Businesses bear much of that burden through increased health care costs, absenteeism, and lost productivity. However, employers remain largely unaware of just how severely addiction is impacting their companies.

The impact of substance misuse on businesses

Health care costs are more than 3 times higher for employees who misuse any prescription pain medication — and up to 9 times higher for those who misuse opioids specifically.5,6 They’re more than twice as likely to be hospitalized — and their hospital stays are more than twice as long. These employees also miss a whopping 29 workdays a year — 3 times more than average.7

Many employees living with addiction and substance use disorders have co-occurring mental health conditions. For example, depression and anxiety are 4 times more common in people who misuse pain medication.8 Dependence on more than one substance is also common. Nearly 40% of people who misuse illicit or prescription drugs also misuse alcohol.9 The associated health risks for employees — and costs to employers — add up quickly.

Consider this: How can a chronic condition be grounds for termination? About 3 in 4 employers believe prescription drug misuse is a disease that should be treated like any other chronic condition. At the same time, nearly 2 in 3 think it’s a justifiable reason to fire an employee. Employers’ conflicting views on prescription drug misuse: 71% say it’s a disease; 65% say it’s grounds for termination.

Seeing the person behind the addiction

According to the American College of Physicians, addiction is a disease that can be treated and managed successfully — not unlike diabetes. But in most workplaces, it’s treated quite differently. Drug-free workforce policies typically focus on penalties — frequently resulting in termination — instead of helping employees get and stay healthy. Such policies may perpetuate the stigma and feelings of shame and fear that prevent so many people from seeking help.

It’s possible for high-performing employees who bring tremendous value to their organizations to also struggle with substance misuse or addiction. If they’re simply fired, these employees lose the income, routine, social support, and self-confidence they get from their job — along with health benefits that could have helped them access treatment. And on top of losing team members with institutional knowledge and experience, the employer spends 20% of each former employee’s annual salary to replace them.10 With 25% of employers struggling to find new recruits who are opioidfree, it’s time to explore a different approach.11

Recovery is good for business

It’s true that treatment for addiction costs money. But every dollar a business spends helping employees get treatment saves $4 in health care costs.12 On average, each worker in recovery saves their employer $3,200 annually. For some industries, it’s more than $8,400.13

Investing in employee recovery benefits everyone. Recovery is a lifelong commitment that goes beyond rehabilitation, and it can transform a person personally and professionally. Workers in recovery tend to be model employees — extremely loyal and dependable, with fewer missed workdays and lower turnover rates than any other group.14

Treating addiction is a worthy investment. Every dollar spent on treatment saves 4 dollars in health care costs.

How to become a recovery-ready workplace

While prevention should be part of every workforce health strategy, support shouldn’t end there. In a workplace where treatment for addiction is encouraged rather than stigmatized, employees have better chances of recovery. It also sends a hopeful, positive message to all employees — and helps foster an inclusive work culture.

Take a stand against stigma
Stigma is one of the primary reasons why 90% of people who need treatment for addiction never get it.15 When people feel safe to talk openly and honestly about addiction and recovery, that stigma starts to break down. Just knowing that their employer views addiction as a treatable illness — and believes that recovery is possible — can empower employees to speak up and seek help.

Make recovery accessible
Employees need to know — and trust — that they can access treatment confidentially and without jeopardizing their jobs. Make sure your health plan covers all possible options, including behavioral therapy, addiction and recovery services, and medications like buprenorphine and naltrexone. Offer an employee assistance program (EAP) that can help employees navigate available resources.

Provide ongoing support
Some people continue working while they get treatment for addiction. Others need to take time off. Either way, it’s important to remember that treatment is just the first step. Creating a supportive work environment for recovering employees is just as important for long-term sobriety:

  • Make reasonable accommodations, like flexibility to attend therapy during business hours.
  • Consider making work events alcohol-free to be more inclusive of employees in recovery.
  • Support a healthy work-life balance. Recovery requires time for self-care and social support, so employees need to know it’s OK to take breaks and time off.

To end this current crisis, attitudes about addiction need to change. We need to start seeing it for what it really is — a treatable health condition that people can and do recover from. As an employer, you can make a difference — because when businesses implement proactive, compassionate programs designed to break down stigma and connect employees to support, recovery happens.

Learn about Kaiser Permanente’s proactive approach to opioid management >

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