Opioid use disorder (OUD) is a chronic, relapsing disease with significant economic, personal and public health consequences that directly impact workplaces.
Hampshire County is no exception, and Hampshire HOPE has launched a series of trainings that aim to better equip local employers to meet this public health crisis.
According to a report issued by the Centers for Disease Control and Prevention, opioid use disorder represents an economic burden that tallies up at around $78.5 billion annually in the United States for health care, lost wages and productivity and OUD treatments, as well as the costs associated with courts, prisons and probation. Meanwhile, the American Action Forum estimates the overall cost to the economy and U.S. workforce loss at $702 billion due to opioid-related employee expenses and productivity losses between 1999 and 2015.
“The opioid epidemic is a public health and economic emergency for the Commonwealth. The crisis affects every aspect of life including the workplace,” according to “Opioids in the Workforce,” a research brief released last fall by the Institute for Behavioral Health at Brandeis University’s Heller School for Social Policy and Management. “It is creating workforce shortages, increasing turnover, absenteeism, presenteeism (working while sick) and costing millions in healthcare costs.”
At the same time, it’s also true that many people with substance use disorder are productive workers. “Alcohol or other drugs can impact people’s performance, but we know there are many people who use drugs and function in the workplace,” said J. Cherry Sullivan, coordinator for the Hampshire HOPE coalition. “It’s important to find ways to support them staying employed.”
Still, a problem of this magnitude calls for an all hands-on deck approach beyond public health professionals and mental health and medical providers. Employers are on the front lines when you consider the amount of time most workers spend on the job. They have a stake in the effort to find innovative solutions.
The “Opioids in the Workforce” brief contends that the problem has not received enough attention, especially considering the pivotal role of employers play in the lives of their employees.
“While many employers are concerned with OUD in the workforce, there is no consensus on the best approaches and stigma remains a major obstacle to action,” according to the report. “The breadth of this epidemic is moving many employers to take action, as the opioids increasingly affect their employees and business.”
The trainings cover the physiology of addiction and the use of the overdose reversal drug naloxone (often referred to as Narcan) as well as how to support employees who may be dealing with opioid use disorders and other substance use issues.
“Employers should care about this issue in terms of the health and wellness of customers and employees,” said Sullivan. “A lot of what we hear from business owners is ‘we don’t know how to support people with substance use disorder’ or ‘we think one of our employees might be struggling, but we don’t want to ask.’ Or employees are distracted because their loved one is struggling with substance use disorder.”
At the HOPE trainings, employers are taught that they should look at substance use disorder in much the same way they would a health condition such as diabetes or other chronic illnesses.
“Because this is a medical issue, we ask them to treat it as such,” said Sullivan. That might mean being flexible with time off for medication-assisted treatment (MAT) or therapy, just as they might for other health issues that need medical care.
“That conversation is really interesting because managers get that ‘a-ha’ moment. And we feel like people are really getting it in the end,” said Sullivan.
The effort is already beginning to pay off. A recent training with a local housing authority, for example, prepared a maintenance worker to respond calmly and effectively to an incident involving an opioid overdose on the property. He reported back that he could see the woman in trouble was experiencing feelings of shame, and he responded in kind.
Beyond people struggling with active addiction issues, it’s important that employers are aware that their workforce may include many people in recovery who are valuable workers, too. Gainful employment is a key factor in recovery for many people.
“A job is so much more than a means to be financially stable, though that is important,” said Lynn Ferro, director of the Northampton Recovery Center (NRC). “For some, a job is essential in rebuilding self-esteem, confidence, personal fulfillment, self-respect and connection.”
This is why the NRC spends time with members working on job readiness skill-building in a variety of ways. At the same time, people recovering from substance use disorder benefit from employers who understand that recovery is an ongoing healing process.
“This informed approach requires the willingness and respect of both employers and employees,” said Ferro.
Meanwhile, certain types of work are known to increase risks for people who have been exposed to opioids. For instance, construction workers, who are at higher risk for injury, also face increased risk for developing substance use disorder.
According to a report from the state’s Department of Public Health, injured workers were more commonly prescribed opioid painkillers. And nearly 25 percent of overdose deaths in the commonwealth during a five-year period occurred among construction workers.
The Heller School’s “Opioids in the Workplace” report suggests a number of recommendations, including support for anti-stigma campaigns, encouragement of “recovery friendly” workplaces, efforts to remove barriers to treatment (for example, co-payment or prior authorization for MAT) and better use of employee assistance programs, which the report called an “underutilized resource.”
“Increased employer engagement is necessary to address the crisis — and employees need targeted tools and resources to do so,” states the report.
To that end, Hampshire HOPE is collaborating with Tapestry to develop resource packets for businesses at the request of employers seeking more guidance. The packets will include signs to post in bathrooms about safe needle use, naloxone and literature about the best ways to support employees who may experience substance use disorder or those who may have loved ones struggling with addiction.
Another project on the horizon is a series of focus groups with employees in professions known to be at higher risk for exposure to opioids. That effort will begin with conducting focus groups for people working in restaurants, to find out what the prevalence of use is and what supports might help.
Michele Farry is assistant program coordinator for the Hampshire HOPE opioid prevention coalition run out of the city of Northampton’s health department.
Hampshire HOPE members contribute to this monthly column about local efforts addressing the opioid epidemic.