Following President Donald Trump’s declaration last week of a public health emergency relating to the nation’s opioid crisis, Employee Benefit Adviser spoke with Chatrane Birbal, senior advisor for government relations at the Society for Human Resource Management, about the role that can play in delivering services to employees and their family members who are in the grips of a painkiller and heroin addiction. Edited excerpts follow.
EBA: Is there a role benefit executives can play in combating opioid abuse?
Birbal: Yes. However, I should note that the issue of legally prescribed medications is not new for employers. According to research, 71% of U.S. employers say they have been affected in some way by employee misuse of legally prescribed medications, including opioids. Nonetheless, the announcement by the administration renews and raises awareness of this growing crisis in the U.S.
The prescription painkiller epidemic poses a unique challenge for employers. These medications have the potential to cause impairment, increasing the risk of workplace incidents, errors and injury even when taken as prescribed.
As a result, employers over the years have been — and will continue —implementing benefits to employees to help address the issue. There could be an increase in benefits like telemedicine services, which would broaden the reach of medical treatment to rural areas where doctors are often in short supply. In addition, employers (if they have not already done so) may review service coverage for behavioral health and/or employee assistance program needs. An evaluation of the behavioral health portions of health insurance policies and EAP contracts will help to ensure employees are covered for abuse of prescription drugs.
EBA: Will employees’ use of drug rehabilitation facilities and sober living services be extended? If so, who pays for it?
Birbal: Combating substance abuse can be costly. Add that to increasing healthcare costs and that means that employers’ ability to implement some benefits, such as rehab and sober living treatments, will be limited.
EBA: What else can employers do?
Birbal: One option that employers may take is to partner with health care and workers’ compensation insurance providers. Working closely with these partners helps employers understand the extent of opioid use and the need for programs to prevent and manage opioid abuse. Employers could also create/update prescription drug policies and add prescription drug testing to illicit drug testing.
As a matter of fact, in January of this year, the U.S. Department of Transportation, which requires drug-testing for those in certain safety-sensitive jobs such bus drivers and airline pilots, proposed to add opioids to its tests. The U.S. Department of Health and Human Services has proposed to add opioids to its drug tests for federal workers.
EBA: Is there a role benefit advisers in dealing with the epidemic?
Birbal: Most employer-sponsored health benefit plan offerings have already been solidified for 2018. However, looking ahead, it is possible that advisers would recommend adding alternative therapies including acupuncture, chiropractic treatment, yoga and more to plan offerings. In addition, benefit advisers may recommend limiting the amount of days that the employer contributes for the costs of some prescription drugs like opioids. It could also be recommended that HR professionals work with their claims managers and pharmacy benefit managers to intervene as early as possible to avoid long-term use of potentially addictive prescription painkillers. Pharmacy benefit managers also have access to software programs that can flag the quantity and duration of certain prescriptions.
As an aside, this could be tricky because the Americans with Disabilities Act may protect an employee’s use of over-the-counter or prescription drugs to treat a disability.
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