What is your most pressing employee health and safety issue today? It’s not cholesterol or weight or sitting, or probably anything else you are prioritizing. Instead, by far the major health and safety 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 opioid prescription written for every adult in the US, 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 other things you, as administrators, need to know:
- Opioid abuse has jumped 500% in the last 7 years.
- 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.
- The $78-billion all-in cost in the US of opioid use, abuse, and treatment works out to maybe $756/employee/year. To put that in perspective, that’s about ten times what you spend on heart attacks and diabetes events (not that those aren't important too!).
- Workers compensation claims costs are ten times higher when long-acting opioids are involved.
- Your ER visit claims coded to opioid issues have probably increased threefold since 2003.
Yes, I know, that is only six factoids (including the one in the opening paragraph) and I promised seven. No, this is not wellness industry math. Stay tuned. Speaking of wellness, you can’t look to your wellness vendor to solve this problem. If their biometric screens included drug-testing, the employees who need to submit to them wouldn’t. (The legality of that would be very questionable anyway.)
A health risk assessment question: “Are you addicted to painkillers or heroin?” is going to generate -- at best -- the same level of candor wellness vendors observe (or not) 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, your health literacy vendor – whether Quizzify or someone else – 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 just pure education, the answers being pure facts. (In the case of Quizzify, the facts are stamped with the Harvard Medical School “shield” for even greater credibility, reflecting that each has passed review by doctors at Harvard Medical School.)
For Employees Not Already Using Pain Meds
First, 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.
- It can take as little as three days of use before the first signs of addiction occur. Even something as minor as prophylactic wisdom teeth removal (not generally recommended by Quizzify anyway) can generate 3 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 than a low dose.
- Employees’ kids are taking prescription pain meds in numbers far exceeding those of previous generations because they believe them to be safer than street drugs, and easier to get hold of (often from the parents’ medicine cabinets).
For Employees Using Pain Meds
As mentioned, the percentage of employees using pain meds, 4.6% on average, is roughly the same as diabetes. The cost of treating them – and 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 and/or having a criminal record also impede the likelihood of seeking help. Your health literacy vendor should be able to “customize” questions for you to overcome these natural impediments.
Examples of questions that we here at Quizzify have customized include:
- 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?"
Where to from here?
Your budget allocation for health, wellness and safety should be in proportion to the priorities for health and safety. And 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 them or annual compliance training. It’s time to reconfigure these priorities. Whether with Quizzify or some other health literacy vendor attached to some other leading medical school, teach employees how to avoid, manage and treat opioid addiction before it is too late.
And by “too late,” I mean the sixth of the factoids you need to know: Far exceeding diabetes and heart attacks, overdoses are the leading cause of death for employees under 50.