Opioid-use disorders: The role of the employee assistance program
For decades, employee assistance programs have offered a low-barrier, confidential way for employees to seek help quickly — before a small problem becomes a larger and costlier one. Unfortunately, in the case of opioid abuse and pain-pill addiction, the situation often reaches a crisis in a matter of days or weeks, as opposed to the months or years it typically takes for problems like alcohol abuse to reach a flash point.
While EAPs can play a vital role in helping employers address the problem of opioid abuse, in order to truly be effective, the program must be built and positioned carefully:
1) Position the EAP as the entry-point for all mental health and substance abuse services. Employees with an opioid-abuse problem require a significant level of advocacy and support. Consider putting the phone number for the EAP on the company insurance card, with language that steers all employees seeking help for a mental health or substance abuse problem to the EAP first. Similarly, ensure that customer service representatives, benefits specialists and any other internal or external health plan experts or advocates are trained to refer employees to the EAP for assistance. The EAP should spearhead and deliver this external training initiative.
2) Ensure all calls into the program are answered live 24/7/365 by a licensed, experienced clinician. When an employee with an opioid-abuse problem calls the EAP, the first person he or she speaks with must be an expert. With opioid abuse, problems escalate quickly and crises are common. In most cases, the window of opportunity when an opioid user is receptive to help is short. An experienced clinician can reinforce the positive steps an employee is taking and use evidence-based strategies such as Motivational Interviewing and screening and Brief Intervention and Referral to Treatment to enhance motivation to change and increase the likelihood that the employee will follow through with treatment.
3) Confirm that the EAP conducts a comprehensive mental health and substance abuse assessment for every participant. Stigma is real, and employees often minimize their problems. A comprehensive clinical assessment that includes evidence-based screening tools will ensure that no underlying issues are missed. Then, based on the assessment, the EAP clinician can work collaboratively with the employee to develop the most clinically appropriate care path – and provide guidance to the highest-quality and most cost-effective, in-network treatment options. By ensuring employees always receive referrals to the ‘right’ providers and facilities, the EAP can have significant and measurable impact on healthcare costs.
4) Fully integrate the EAP with the mental health and substance abuse component of the employee medical plan. Unlike most other common concerns presented to EAPs, like relationship problems, stress and lower-grade depression that can often be resolved through short-term counseling, opioid abuse or addiction will likely require longer-term and highly-structured treatment plan. That means using resources within the employee’s medical plan. A variety of treatment options are available to battle opioid abuse, including detoxification, inpatient rehabilitation, outpatient behavioral health counseling and medication assisted treatment. Often, the most effective solution is a combination of multiple treatment types. It’s important that integration between the EAP and the medical management component of the medical plan is sound. By ensuring a secure, warm hand-off from the EAP, the employee’s case continues to be handled appropriately from start to finish. When addressing opioid addiction, the importance of ongoing case management at every stage of the treatment process cannot be overstated.
In addition to assisting employees who already have a problem, an EAP can also be an organizational resource to assist employers who wish to take a more proactive role in addressing issues related to employee opioid use and abuse. The following are just a few of the many ways that an EAP can support the organization:
- HR/management consultation
- Drug-free workplace policy development
- Employee and supervisor education and training (including ‘reasonable suspicion’ training)
- Formal management referral services
- Substance abuse professional services (for employees whose job duties fall under federal Department of Transportation regulations)
Whether an employee seeks help on his or her own, or the employer recognizes a problem and refers the worker in a more formal manner, an effective EAP can play a critical role in addressing and resolving opioid-use disorders. However, in order to maximize the effectiveness that an EAP can have, the program needs to be positioned, marketed and integrated effectively.