6 Shocking Facts on Opioid Abuse

The $78 billion all-in cost in the U.S. of opioid use, abuse and treatment works out to about $756 per employee per year. 

What is your most pressing employee health issue today? It’s not cholesterol, weight, sitting or probably anything else you are prioritizing. Instead, by far the major health menace facing your employee population is the opioid epidemic — which, according to Harvard Medical School psychiatrist John Kelly, has reached “DEFCON 5.” DEFCON 5 is right. There is roughly one opioids prescription written for every adult in the U.S., and the total addiction rate is estimated at 4.6%, which makes it higher than alcoholism and roughly comparable (in the employed population) to diabetes. Here are five things you need to know:
  1. Opioid abuse has jumped 500% in the last seven years.
  2. The price per milligram of morphine-equivalent paid by employees has declined about 75% in the last 15 years. This is due to more generous coverage (by you!), more use of the formulary and, most distressingly, more pills per prescription. There is virtually no product whose use doesn’t increase as the price falls. And there are very few products whose price falls that much.
  3. The $78 billion all-in cost in the U.S. of opioid use, abuse and treatment works out to about $756 per employee per year. To put that in perspective, that’s about 10 times what you spend on heart attacks and diabetes events (not that those aren't important, too!).
  4. Workers' compensation claims costs are 10 times higher when long-acting opioids are involved.
  5. Your ER visit claims coded to opioid issues have probably increased threefold since 2003.
(Yes, we know, that is only five facts. and we promised six. Keep reading...) How do you solve an opioid problem within your organization? You can’t look to your wellness vendor to solve this problem. If biometric screens included drug-testing, the employees who need to submit to them wouldn’t. (The legality of the testing would be very questionable anyway.) Asking a health risk assessment question: “Are you addicted to painkillers or heroin?” would generate — at best — the same level of candor wellness vendors observe when they ask about drinking and smoking. You can’t address an addiction that an addict won’t admit to having in the first place. However, a health literacy vendor – ideally, my firm, Quizzify – can raise awareness of the hazards of opioids in your employee population. Because health literacy quizzes don’t require personal health information, there is no opportunity to lie, no one is being singled out and no one needs to worry that the results aren’t confidential. It’s simply, purely education. The answers are pure facts. (And in our case have passed review by doctors at Harvard Medical School.) See also: The True Face of Opioid Addiction   For employees not already using pain meds: Firstly, employees who are not currently using prescription painkillers need to be made aware of the risks of starting. If there is one health literacy risk worthy of attention — meaning one risk where curing a knowledge deficit (as opposed to trying to change behavior, as with smoking cessation or eating habits) matters — it’s in opioid addiction prevention. A few facts:
  • It can take as little as three days of use before the first signs of addiction occur. To put this into perspective, even something as minor as prophylactic wisdom teeth removal (not generally recommended by Quizzify anyway) can generate three days of painkiller medication.
  • If you use a 10-day supply as directed, you have a 20% risk of becoming a long-term user.
  • Dose matters. A lot. A high dose for a short duration is 40 times as likely to cause an opioid use disorder as a low dose.
  • Employees’ kids are taking prescription pain meds in numbers far exceeding those of previous generations. This is because they believe them to be safer than street drugs and are easier to get hold of (often from the parents’ medicine cabinets).
For employees already using pain meds: As mentioned, the percentage of employees using pain meds, 4.6% on average, is roughly the same as the percentage with diabetes. The cost of treating those on pain meds – and their productivity losses (not to mention the possibility to pilferage or other crimes to support the habit) – is much higher than diabetes. Further, employees are unlikely to seek help on their own. Use of medications designed to treat opioid addiction has grown only about a fifth as fast as opioid use itself. And many employees either don’t know where to turn or are concerned that their EAP conversations are not confidential. Fear of job loss or having a criminal record also impede the likelihood of seeking help. Your health literacy vendor should be able to create the education for you to overcome these natural impediments. Quizzify's opioid abuse education includes:
  • Specific contact information for the EAP.
  • “What if I think a coworker is opioid-dependent?”
  • “Are there resources for family members?”
  • “Can I get or renew pain meds from the on-site clinic?”
  • “Is opioid treatment a covered benefit?”
  • “Will human resources find out I am getting opioid treatment?”
  • "What are signs that my children are abusing painkillers?"
What can you do to help? Your budget allocation for health and wellness should be in proportion to the priorities for health and wellness. As of now, you are likely spending less on educating employees on opioids (not to mention on other health literacy imperatives) than on, for example, weighing employees. Likewise, employees are probably spending more time figuring out how to cheat on their weigh-ins than on understanding the hazards of opioid use. It’s time to reconfigure these priorities. Teach employees how to avoid, manage and treat opioid addiction before it is too late. See also: Opioids: Invading the Workplace   And by “too late” we mean #6 of the facts you need to know: Far exceeding diabetes and heart attacks, overdoses are the leading cause of death for employees under 50. We invite you to take Quizzify's Opioids Awareness Quiz and share it with the top executives, HR administrators and wellness champions within your organization. Your awareness that something needs to be done now will increase. Quizzify offers educational quizzes about opioids for employees. That might be a good place to start.

Al Lewis

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Al Lewis

Al Lewis, widely credited with having invented disease management, is co-founder and CEO of Quizzify, the leading employee health literacy vendor. He was founding president of the Care Continuum Alliance and is president of the Disease Management Purchasing Consortium.


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