Employers Unsure of Role in Combating Opioid Epidemic

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By Hassan A. Kanu

Weiland’s Market, a specialty grocer in Ohio, has been dealing with a somewhat novel workplace issue, even after more than 50 years in business.

“It’s typically difficult to hire people but right now its practically impossible to find good, conscientious folks who can pass a drug test,” Sheila Freeman, Weiland’s business manager, told Bloomberg BNA. “I talk to owners in the restaurant industry, and I’ve actually heard ‘we wouldn’t have servers, we wouldn’t have a staff if we implement a drug-free [workplace] program.’”

The Buckeye State has been called the “face of the nation’s opioid epidemic.”

“Ohio is ground zero for this heroin [and opiate] crisis,” Republican state Senator Rob Portman told Bloomberg BNA. “At nearly double the national average, Ohio has the fourth highest rate of overdose deaths in the country.”

The attendant problems have affected most employers in the state. “There’s no question that the opioid epidemic has had an impact on businesses and employers,” Portman said. “People struggling with an addiction are not reaching their full potential and too often are putting themselves or others at risk.”

Weiland’s stands out among Ohio employers. Where many private sector employers seem unsure of how or whether to act, the Columbus grocer has implemented a robust drug-free workplace program (DFWP) focused on treatment and rehabilitation.

“We address substance abuse specifically, from providing someone to just talk to, all the way to assessment and treatment,” Freeman said. Weiland’s even agrees not to discipline employees who fail a random drug test “so long as they agree to go for an assessment and any recommended treatment,” she said.

“I’ve had a guy, a handful, test positive, go for an assessment, then into treatment, and when he returned he actually came in and thanked me later,” Freeman said. Weiland’s program likely costs more than regular psychiatric health insurance, but “we actually believe there’s a cost savings here [in terms of] problems with attendance or employees just generally being unproductive.”

Federal and State Efforts

States and the federal government are taking steps to combat the epidemic.

President Donald Trump’s administration announced last week that the federal government will soon begin disbursing $485 million to states to aid their efforts in fighting opioid addiction.

In Congress, Sens. John McCain (R-Ariz.) and Kirsten Gillibrand (D-NY) recently introduced legislation to prevent over-prescription of opioids. Portman in February joined Sens. Amy Klobuchar (D-Minn.), Marco Rubio (R-Fla.) and Maggie Hassan (D-N.H.) to introduce the Synthetics Trafficking & Overdose Prevention (STOP) Act to help stop the inflow of opioids like synthetic heroin from other countries.

State and local governments have also taken a portion of the reins in the fight.

The National Governors Association formed a multi-state compact in 2016 to address the epidemic. The West Virginia attorney general sued drug distributors the same year, alleging they intentionally flooded the state with prescription opioids. And in February 2017, officials in Everett , Wash. sued the manufacture of OxyContin, claiming it intentionally turned a blind eye to illegal trafficking.

Employers Lagging Behind

But many employers are not sure how best to respond.

Employers have difficulty understanding the full impact of substance abuse in the workforce, Julie Stich, associate vice president of content for the International Foundation of Employee Benefit Plans, told Bloomberg BNA.

“Part of it is they may not comprehend how it impacts a worker’s absenteesim or their physical health,” Stitch said. “A lot of it, the bigger picture, is that it’s hard to identify people who are suffering from this challenge and hard to get them to talk about it.”

Portman told Bloomberg BNA that he believes “employers have a unique role” because they’re in a position “to help people before they lose a job or end up in the criminal justice system.”

“Stigma is a particular barrier in the workplace [but] my hope is that employers will recognize that addiction is a disease and not a moral failing,” he said.

Working Partners works with employers to develop comprehensive DFWPs, and has many clients in Ohio, including Weiland’s Market. Dee Mason, the organization’s CEO, said businesses should “become involved” in solution-seeking when opioid abuse affects their workforce. “Don’t just shut your eyes or shove people out the door,” Mason said.

May Not Have Full Grasp of Issue

Benefits plans and insurance policies are also a tool to combat the problem in the workplace. The results of a 2016 IFEBP survey, Mental Health and Substance Abuse Benefits, contain some indicators about employers’ benefits-centered strategies.

The foremost approach is to require “prior authorization” of opioid prescriptions in excess of a certain number of days. Generally speaking, though, such practical processes can be circumvented fairly easily, or rendered ineffectual by an unscrupulous or careless medical professional.

Stich affirmed that the second most-employed strategy here—conducting drug claims analysis to identify patterns of abuse—may be one of the most effective.

“An analysis would be an effective way to at least highlight people who are constantly refilling and perhaps displaying drug-seeking behavior by going to different physicians,” Stich said. “Claims can be de-identified, but you could at least glean something” and contact the prescribing physician and employee.

Affected Workers Viewed as Problem to Eliminate

Employers can, of course, develop components of a robust DFWP that aren’t centered around benefits.

Two of the most important components are training supervisors to identify symptoms of drug abuse and a concrete plan for treatment and assistance, Mason said.

Mason often helps employers identify a “business-centric” treatment provider. “Community service providers aren’t often well-trained to work with businesses,” she said.

“Employers don’t always understand that the majority of people who test positive [for drug use] aren’t dependent or addicted,” Mason said, and they will “usually just say ‘we’ve gotta get this person out of here.’”

Once employers are educated and trained, they become more receptive to increasing their intervention efforts, Mason said.

“We need to understand that the opioid epidemic is far reaching and there are people who have become addicted to opiates later in life who have never had a history of drug use,” Portman said.

Tendency to Act After Crisis

Mason explained why Working Partners’ clients have taken a step that many employers don’t. “We’ve recognized several triggers for an employer to kick things up and say they have to do something different,” she said.

The first is a need to comply with federal or state obligations, like Department of Transportation standards for trucking companies. The second is “when they have an ‘oh my God!’ incident” or a crisis that can’t be ignored.

“At that point they may be facing legal exposure so it’s not about shoving people out the door anymore,” Mason said. “If there’s [a serious chance] of liability that becomes a trigger and they say ‘oh, this is what I should’ve been doing.’”

A third trigger exists because many people have personal exposure to drug abuse. “We’re talking risk managers, CFOs, HR folks, those people sometimes recognize the [productivity and bottom line] losses due to substance abuse” and will therefore act.

It’s prudent for employers to be proactive, given the epidemic proportions of opioid abuse. But Mason said her experience indicates that many are reacting to a crisis when they establish a DFWP, another indicator that they simply don’t understand the need to act.

Businesses Report Positive Results

Angie Booth-Peters, vice president of human resources at commercial real estate developer Equity LLC, told Bloomberg BNA that she worked with Working Partners in a previous job at a state contractor. The contractor had a DFWP because it was legally mandated. “When I switched companies I realized the need was there for this employer as well, and rallied to get it in place,” Booth-Peters said.

“There’s always a stigma when talking about substance abuse,” she said. “Employers in particular start to feel like they’re invading privacy or mandating things outside of their realm, so they need to be educated and showed that this is to help your employees and show them you care.”

One key is to “make sure you find a trainer that’s really passionate and can make this sometimes dry subject more engaging,” Booth-Peters said.

One Equity worker who was initially “agitated because he felt the company was trying to have too much control over him” later thanked Booth-Peters because the educational components helped him recognize that a family member was dealing with substance abuse.

“Once employers realize programs like this don’t eat up productivity, but instead actually contribute positively to their bottom line,” they become much more willing to establish them, Mason said.

One incentive for Weiland’s Market: Ohio offers discounts on workers’ compensation to businesses with DFWPs.

“That was really the impetus, but what we found out once we got into it is it’s a significant way to improve safety and hire a dependable, conscientious staff,” Freeman said.

“We need to make sure that people struggling with addiction can find support and recovery- the community and the workplace can help support this,” Portman said.

To contact the reporter on this story: Hassan A. Kanu in Washington at hkanu@bna.com

To contact the editors responsible for this story: Peggy Aulino at maulino@bna.com; Terence Hyland at thyland@bna.com; Christopher Opfer at copfer@bna.com

Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.

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