Substance dependence, in particular purveys significant economic burden unto both the individual and society, and employers bear a brunt of this cost. This financial hit to employers is both direct and indirect in nature, and relates to costs tied to workplace productivity as well as those derived from employee healthcare.
The cost to employers of chemical dependence can be likened across multiple substances, and include the technically legal. Employee excessive alcohol consumption has been associated with increased work injuries as well as absenteeism, all of which translate to decreased output. This translates to an annual employer cost that exceeded $28.6 billion for 1998-2000, and $13.2 billion of this was related to alcohol-involved injuries on the job. Opioid abuse, unintended use, and dependence (“opioid abuse”) has recently been declared a public health emergency, affecting 5 million people and leading to 17,000 deaths in the US every year. Opioid medications are amongst the most effective for chronic pain management, but carry significant addiction and abuse potential, and Americans consume a whopping 80% of the world’s opioid supply despite constituting only 4.6% of the world’s population. The rate of overdose deaths increased by 14% from 2013 to 2014, ad half of these are prescription drug-related.
What is the impact of chemical dependence on businesses (employers), and how could providing information/access to appropriate resources present a reasonable return on investment?
Opioid abuse extends across multiple age groups and populations, and includes individuals of working age and their dependents., A recent study by Rice, et. al (2014) utilized claims data to estimate the extent of related costs to employers, and found prevalence to increase steadily from 6.7 to 18.6 per 10,000 from 2006-2012. Diagnosed abusers had, on average excess annual healthcare costs of $10,627 per patient as well as $1,244 in excess annual work-loss costs. Diagnosed abusers missed seven extra days of work on average, were more likely to be male and also more likely to have increased comorbidities, including a 20% more likely comorbid mental health disorder. These findings likely underestimate total cost given they do not include the undiagnosed. Rice, et. al (2014) estimate this rate to include 61.4 individuals per 10,000, which implies a ratio of 3.3 undiagnosed per diagnosed abuser in the United States. This translates to a per member, per month (PMPM) healthcare cost comparable to that of colorectal cancer (US$4.38), chronic obstructive pulmonary disease (US$5.35), obesity (US$4.84–US$7.78) and osteoarthritis (US$6.64).
Raising awareness of and directing employees to information regarding responsible opioid use, as well as the danger of and resources to help with addiction could pose significant economic advantage to employers.
Raising awareness of and directing employees to information regarding responsible opioid use, as well as the danger of and resources to help with addiction could pose significant economic advantage to employers. This would be especially salient in the setting of workplace-related injury, where opioids may be prescribed acutely as reasonable adjunct. Appropriate intervention at a critical moment could profoundly impact outcomes, and the pain and trauma associated with acute injury often renders patients quite vulnerable. Individuals may forgo soliciting medication-related advice from their doctors at this time due to any number of factors that may be trauma or stigma-related, but often have questions following their visit. The projected improvement in outcomes will readily translates to decreased costs for employers, and help to promote healthy paradigms within the home and workplace, as well as the community, at large.
Exclusive for Reach Out Recovery by
Jeffrey E. Vogel, MD, MPH
Marisol Sepulvida, DO, MPH
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