Employers Respond to Rising Substance Abuse with Treatment, Support

When the COVID-19 pandemic lockdowns began in March 2020, employers scrambled to support employees who suddenly were working from home full time, often in close proximity with family members, partners and roommates. These new living and working arrangements led to a spike in stress, anxiety and depression for many employees and, as a result, the potential for alcohol and drug abuse—even among those who had never had a problem before.

A 2021 New York University School of Global Public Health survey of 5,850 people who drink alcohol found that 29 percent have increased their drinking during the pandemic. However, some populations are more vulnerable than others. For example, those experiencing depression were 64 percent more likely to increase drinking, while those with anxiety were 41 percent more likely to do so.

Similarly, 40 percent of people under age 40 report increased drinking compared to 30 percent of those 40 to 59 years old and 20 percent of those over 60.

With work-from-home employees and social distancing among employees who must work onsite, it can be difficult to recognize the signs of employee substance abuse. "A high-functioning alcoholic can get a lot done," noted Yusuf Sherwani, CEO of Quit Genius, a digital clinic for addiction treatment. As a result, employers have started looking for ways to use existing treatment and support options available through mental health benefits and employee assistance programs (EAPs), along with telehealth and other emerging technologies, to support employees struggling with substance use and addiction.

Below are examples of actions that employers have taken.

Exploring new treatment options and approaches.

In December 2020, The Hartford Financial Services Group added two prescription digital therapeutic (PDT) apps to its pharmacy formulary, one for people with general substance use disorders and one for those dealing with opioid use. PDTs, which must be approved by the U.S. Food and Drug Administration, combine a relevant prescription for addiction treatment with digital support that includes prompts and access to cognitive behavioral therapy. The app also can track lessons completed, patient-reported substance use and drug screening results.

The objective is to provide the medication and tools to help people manage their behavior while also gathering data that could help identify when and why they face cravings and triggers that could lead to substance use. "Over time, this shows a pattern and allows individuals and treatment providers to get predictive on cravings" and to understand the circumstances under which someone might be reaching for a substance, said Tom Warters, The Hartford's head of total rewards and HR operations.

The Hartford also began to take steps to prevent substance use problems. For example:

• To reduce addiction risk, the company began to shorten prescription length for opioids from seven to five days for employees age 25 and over, and to three days for those under age 25
  

• To provide alternatives to opioids for pain management, the company began paying for three physical therapy or chiropractic visits for employees.

"We began focusing on this well before the pandemic, but the pandemic exacerbated the situation as people became more isolated," said Warters. "Stress is everywhere, and you have situations where people are struggling, especially when isolated, alone, late at night, and so on."

By providing constant access to treatment via PDTs, the company is hoping to remove as many barriers to treatment as possible. Due to the pandemic, Warters said, "people are more open to trying new things, including new treatments, that they would have dismissed previously."

Encouraging openness.

Employees may avoid asking for help because of the stigma that is still associated with mental health and addiction, especially if they are still concerned about furloughs and layoffs as a result of the pandemic.

"One of the best ways to remove the stigma is to invite leaders to share their past challenges with employees, [which can] let those who are struggling know they're not alone," said Deb Muller, CEO at HR Acuity, an HR technology provider in Florham Park, N.J.

Telehealth treatment options can also remove mental and physical barriers to seeking treatment, including finding the time for treatment. "People can seek and receive treatment from the privacy of their home—reducing a major barrier to seeking help," said Peter Loeb, CEO of Lionrock Behavioral Health Inc. in Petaluma, Calif. "When you take away the need to commute to and from treatment, and you add in options for [receiving treatment during] different times of the day, treatment becomes a much more realistic option for employed people who may have been wondering how to get the help they need without signaling to their employers that there is a problem," he noted.

Evaluating and communicating resources.

Resources are only worthwhile if employees know about them and use them. "If I could make one change at every company in the world, I'd put a big red button on the intranet landing page that says 'EAP,' " to provide easy access to an employee assistance program, said Dan Jolivet, workplace possibilities consultant with insurance company The Standard in Portland, Ore. "The last thing anyone wants to do when they're struggling with a mental health or substance use crisis is to search through multiple pages on the intranet to figure out how to get help," he said.

This information should include clear language on any coverage limitations, Jolivet advised.

He recommended that employers make sure available health insurance and EAP provider networks meet all the applicable guidelines regarding the number of locally available providers and access for both substance abuse facilities and outpatient providers. It is also a good idea to test "access to make sure that the providers in their networks are actually available to see employees on a reasonable schedule and [not making them wait] six weeks for a first appointment," he said.

With a significant number of employees planning to work remotely for the foreseeable future, "employers may have to look at their benefit plan services to ensure coverage extends to remote employees who may be residing in states not initially considered when the plan was initiated," said Scott Beatty, SHRM-SCP, vice president of HR for Bradford Health Services, a Birmingham, Ala.-based provider of addiction treatment services.

He pointed out that employers can supplement this information with free resources outside the company, such as the federal Substance Abuse and Mental Health Services Administration's websites: SAMHSA.gov and Drugabuse.gov.

Joanne Sammer is a New Jersey-based business and financial writer.

Related SHRM Articles:

Employers Believe Many Well-Being Programs Are Ineffective, SHRM Online, March 2021

One Year into the Pandemic, COVID-19 Fatigue Takes Hold, SHRM Online, February 2021

Today's Young Worker Is Stressed Out and Anxious, SHRM Online, February 2021

Employers Continue to Alter Benefits in Response to Pandemic, SHRM Online, February 2021

Mental Health Apps Offer New Ways to Support Employees, SHRM Online, May 2020