More than 2,600 Michigan residents died in 2017 from an opioid overdose. That’s an increase of more than 80 percent over the last five years, according to data from the U.S. Centers for Disease Control and Prevention. Nationally, the CDC reports that more than 42,000 people died in 2016 from drug overdoses that involved opioids, obtained both legally and illegally. Benefits firm Hylant Group Inc. recently published a risk assessment scorecard on opioids for employers. MiBiz spoke with Guylaine Donavan, a client executive and vice president at Hylant’s Grand Rapids office, about the opioid epidemic.
Are employers generally aware of the epidemic and what’s occurring?
Employers became more aware of it when the pharmaceutical benefit managers — the PBMs that manage the pharmacy program for their health carriers — changed their policies. That did impact some of their employees and their dependents. When the opioid crisis was identified and the CDC launched guidelines on how to manage pain for people with chronic pain, some of those recommendations were to bring back dosages for patients that were dealing with chronic pain.
What has that change done to help work on the opioid problem?
Maybe they could only get 15 days of pain meds instead of 30. Those cases tend to come to the employers: ‘Hey, what’s wrong? How come you’re not covering my medications like you were before?’ This all is an effort to provide alternative treatment to people that have been taking opioids for such a long period of time. Now the prescriptions are issued for very short periods of time because it was discovered that addiction can happen in less than a week’s time.
If a client comes to you and says they have a situation, what are the first questions you’re asking?
Did the person come to you directly or is it through a provider? We’ve had situations come through the employer, but typically it had to do with the prescriptions they are not able to get any longer. There’s frustration with people who have been dealing with long-term chronic pain and not being able to get what they had always gotten.
What are your recommendations when that happens?
In those cases, we’re having them deal directly with their providers, because the providers have all been given guidelines to follow the CDC. Pharmacy benefit managers are following those guidelines and just issuing a certain number of medications. It has become a challenge for those people who have to take them to continue to take them.
What role can employers have in addressing the opioid addiction epidemic?
It’s really just to provide resources for employees. It would be similar to alcohol addiction or any other addictions where they provide resources for employees. Some employers have an EAP (employee assistance program), and it’s just making sure they have one so employees have a resource to get help when they identify that they may be addicted.
What else can they do?
Make sure they have appropriate drug policies. What are your drug policies? Do you have random testing for employees? Those types of things. It’s really looking at your current environment and are you basically providing some guidelines for employees to follow.
If employers want to address opioids with their employees, what should they do?
We can provide a scorecard to employers to help them or give them some idea of the steps to take. One of them is to make sure they have programs and policies in place. The other is just to make sure they are providing some training for their managers so they can recognize, perhaps, somebody that might be dealing with an addiction and what to do about that. And just training them about internal policies and (federal laws) like FMLA (Family Medical Leave Act) and the Americans with Disabilities Act.
In other words, employers can play a role by educating their workforce.
It’s more of an education piece that employers can bring to their population. Let people know that there are alternatives or if someone comes to them, knowing where to send them for help.
What are some of the warning signs that can tell employers that an employee may have a problem?
Erratic behavior, absence issues, and definitely mood swings tend to be some indications. They are the type of things you may see in individuals that you wouldn’t expect. We can take a look at pharmaceutical data, too, and see where you may have a handful of individuals that may be dealing with opioid medications. But quite frankly, we haven’t seen that much of it in the employers’ data that we’ve taken a look at. That’s the good news, but we know it happens.
Do you see employers acting after they’ve had an employee with a problem, or are they taking a more proactive approach?
What I’ve seen is a lot of employers are trying to be proactive about it. A lot of it is just awareness because a lot of us did not even realize this was an epidemic until it was announced just a few years ago. They’re just understanding what the epidemic is and how to deal with it when you have that situation. Most of the employers we talk to are being very proactive and doing what they can to help their population.