Addiction is a brain disorder, a physical disease that changes the way brain chemistry works, not a moral failing. And while miscommunication had led to significant stigma, society — including employers — must change the way it looks at, and reacts to, it, says Caesar DeLeo, M.D., MHSA, vice president and executive medical director, Strategic Initiatives, at Highmark Blue Cross Blue Shield.
“Addiction, or substance use disorder, is a chronic disease, similar to high blood pressure or diabetes,” says DeLeo. “Employees who struggle with chronic disease don’t choose to underperform. We don’t have a cure, but the response rates to treatment for substance use disorder abuse are similar to those of other chronic illnesses.”
Smart Business spoke with DeLeo about how employers can help employees deal with addiction and how prevention, mitigation and treatment can help lessen the impact of the disease on your employees, their families and your business.
How can prevention, mitigation and treatment mitigate risk?
Most people don’t get screened, and 90 percent of those living with substance misuse never receive treatment. Screening is critical to identify those at higher risk to prevent them from moving up that next continuum of the disease. This includes reaching young people in schools and offering programs to increase awareness and delay the onset of substance use and potential abuse.
With mitigation, clinicians help people at risk learn techniques to reduce consumption. Along with that, medications need to be prescribed in a responsible manner.
Treatment is for those with more serious disease, and removing barriers to access, especially stigma, financial barriers to getting medication, therapy and telemedicine services, is critical. Too often, people fail to seek treatment, especially for the misuse of alcohol. This leading cause of death among substance users is treatable, and employers should make resources available so employees can seek the help they need, without attaching stigma.
What role does telemedicine play in treatment?
Providing teleaddiction counseling as part of an employer’s health care benefits package can be as effective as in-person care, and many patients prefer this option. People do not tend to initiate care unless absolutely necessary, but are more likely to do so when a telehealth option is available.
Telemedicine also removes barriers to treatment. People fear judgment, are busy, there can be transportation or childcare issues, work schedules can be a barrier to access. A working person could do a call on a break. And while those at home may not be able to leave for an appointment, they can go to a private room for a call.
The pandemic removed people with substance use disorder issues from regular communication and support systems, and without someone there to help, they can relapse. Telemedicine can help restore those connections and that support system.
Why should employers be concerned about substance use, and what is their role?
Substance use disorder results in losses of $600 billion a year in lost productivity, increased health care costs and increased crime rates, impacting employees, their families and employers. For every dollar spent on treatment, $12 in health care costs are saved, making for a very positive return on investment for employers.
Employers have been unsure how to approach this issue. and have used punitive policies. We are working to inform them about creating alternate policies so that individuals are capable of work and can come back after treatment.
Recovery-friendly companies allow employees to discuss the disease without being penalized, creating a workplace where people can share their experiences with others who are struggling.It’s reassuring to employees to know that their employer is sensitive to real-life issues that impact them, making them more attentive and allowing you to develop a loyal and productive workforce.
The pandemic has created additional stresses for employees, and with remote work, employers may not be aware of their struggles. Providing access to an employee assistance program gives people a place to be screened and guides them to information and confidential treatment.
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