Many of today’s clients at opiate treatment centers hold down regular full-time jobs. In the past, most people attending treatment at methadone clinics came from the bottom rungs of society’s ladder, the people without jobs, oftentimes without homes, and without prospects. Heroin via a needle was the drug of choice for most of them. But a majority of the people seeking treatment today got their start using prescription pain pills.
For many, their long, slow slide into addiction came because they went to a doctor for a toothache, an injury, or an illness, and the doctor saw no reason not to prescribe some kind of medication containing oxycodone or hydrocodone. The drug companies were confidently if underhandedly assuring medical providers that pain pills weren’t addictive, and so the doctors prescribed them freely to anyone who had a health insurance card and a substantiated complaint of pain.
About 15 years later it has become obvious that prescription pain pill addiction has caused an overflow at opiate treatment centers. Too many people start out on a simple prescription to take one or two every four to six hours as needed. When that prescription runs out, the doctor renews it or tries them on another pain pill—usually another opiate medication. Life is too busy to try alternative therapies or take time off from work to go to physical therapy, right? Just right another script.
Before we as a society knew it, we had people “doctor-shopping,” visiting the family doctor and then making an appointment with an orthopedist as well. And the family dentist could always be counted on to kick in another supply of pain pills. Over time, when many of those people could no longer get prescriptions for pain pills, they bought them from someone who knew someone. Or else, if pain pills could no longer be sourced or became cost prohibitive to get they turned to heroin.
Statistics About Today’s Workforce
The result is that we have a workforce with a significant percentage of people addicted to pain pills who need to be seen at opiate treatment centers. They resist the idea of treatment because they can’t take time off from work to go through the assessment process and report for medication on a daily basis. Even if they opt for Suboxone, which can be dispensed from the local pharmacy rather than the methadone program’s pharmacy, they are still required to attend some kind of individual or group therapy. Who has time for that?
Employers have a heightened interest in their neighborhood’s opiate treatment centers because the numbers are out on the impact of opiate addiction on their operating costs. According to Nick Otto in May 2015’s Employee Business News, opioid addiction or dependence costs employers almost $26 billion per year. An analytics company in Seattle estimates that $10 billion of that is attributable to lost work and reduced productivity alone.
The National Council on Alcoholism and Drug Dependence (NCADD) notes that costs of all types of abuse and addiction cost employers a staggering $81 billion annually. The NCADD also believes that of the 14.8 million who use prescriptions of all types illegally, 70 percent of them hold down jobs.
When it comes down to those who abuse opiates to the point of addiction, Otto believes approximately 13 percent of an employer’s workforce require referral to an opiate treatment center. That works out to 13 people for every 100 employed, so you do the math. Three common indicators that treatment is needed include those who have at least 10 opioid prescriptions in a given year; any prescription that provides medication for 120 days or longer; and benzodiazepine prescriptions written that overlap pain pill prescriptions for more than a week.
Of an employer’s healthcare costs, that 13 percent—26 workers if an employer has 200 employees—account for more than 80 percent of total costs. As a worker’s number of opioid prescriptions increase, so does his cost to an employer.
Accessing Opiate Treatment Centers
The people who coordinate credentialing of providers at local opiate treatment centers are seeing an increase in the numbers of employers who want to offer behavioral health benefits, including substance abuse treatment. Over the past two decades it was rare to find an employee health plan with a full palette of benefits that covered addiction services.
Now that employers realize that the opioid epidemic has spread far and wide in this country, they recognize that the profile of the addict has changed. Instead of the alley-skulking, dirty hippie-type of addict common in the 1960s, they realize it might be the well-groomed, articulate people sitting on the front line at desks that they provide.
To combat the problem, employers are making it easier for their affected workers to access treatment at opiate treatment centers. They participate in the selection process of providers for their health plan, and they want providers who prescribe conservatively, according to Otto. Today’s technology can help them identify the types of people in their employee population who might be likely to abuse. They are also doing much more to make treatment accessible, affordable, and—maybe most important—confidential for those who need it.
If You’re the Employee
If you’re the employee holding down a job but worrying because you know your addiction has gotten out of hand, it’s time to get help. Confidential treatment is available to you, and opiate treatment centers follow stringent federal rules that will protect your identity if you reach out for treatment.
The first thing you can do is access the Employee Assistant Program (EAP) offered by your employer. Most companies offer them these days, and you will most likely have multiple free one-on-one sessions with a counselor in your community. In most cases the counselor will meet with you before or after your work hours so you don’t even have to ask for time off work.
Even though the EAP counselor will not be at one of your local opiate treatment centers, the counselor can help you find out if your health insurance plan includes behavioral health benefits, which includes opiate addiction treatment. EAP counselors follow the same strict rules to keep your visit private. The EAP counselor reports to an employer only the number of EAP visits provided in a given calendar year, and no individual identifying information is supplied.
If you call your insurance plan yourself, you can do so without worrying if you’re being judged. The people who answer those phones won’t care why you’re asking, they’ll simply let you know what’s approved by your plan. In many cases you don’t even have to talk to a live person—you can have it faxed or emailed to you.
Remember, too, that once you’ve considered the opiate treatment centers in your locale, you do not have to tell your employer why you are seeing any health professional. The agency where you go will write you a note excusing your absence from work without identifying why. If your supervisor asks you why, you can avoid answering by saying your family doctor referred you for a personal issue. Whether or not the supervisor guesses your reason for going, they will most likely be simply relieved that you are seeking help if you need it.
So, if you’re the employer, keep several brochures about your company’s EAP provider on hand in employee mailrooms and break rooms so they can take one without asking for it. If you’re the employee, pick up one of those brochures and make a phone call. Or call the phone number on the back of your health insurance card for behavioral health services. You can also just call your local methadone opiate treatment center and find out how to get started.
