Overdose Epidemic

What every U.S. employer can do to help end the overdose epidemic

Andis Robeznieks , Senior News Writer

Drug-overdose deaths surged to an all-time high in 2020, according to estimates from the Centers for Disease Control and Prevention that indicate there was a leap of almost 30% in overdose fatalities from 2019.

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The evolving epidemic, which is now being fueled largely by illicitly manufactured and adulterated fentanyl and fentanyl analogs and exacerbated by the COVID-19 pandemic, is believed to have taken the lives of 93,331 people in the U.S. in 2020, compared with 72,151 in the year before.

An AMA issue brief outlines steps employers can take to support employees’ access to evidence-based treatment.

“Treatment with buprenorphine allows patients with opioid-use disorder to lead satisfying, productive lives,” Patrice A. Harris, MD, MA, former AMA president and chair of the AMA Opioid Task Force since its inception in 2014, said in a statement.

This includes being able to work while receiving treatment, Dr. Harris added.

The AMA issue brief cites a study in the Journal of Occupational and Environmental Medicine, which found that “typical” workers miss an average of 10.5 days of work a year. Those with a substance-use disorder (SUD) miss 14.8 days a year, but workers in recovery only miss an average of 9.5 days.

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Employer engagement is crucial in ending the overdose epidemic. The issue brief lists these steps that employers can take.

Ensure employees and their families have access to evidence-based care for SUDs and mental illness. Checking the employee-benefit package to ensure there are no barriers—such as prior-authorization requirements—to accessing evidence-based treatment of SUDs or mental illness is a crucial step.

Revise internal policies to support comprehensive care for patients with pain. Eliminate barriers to nonopioid pain care, including typically high cost-sharing options such as physical therapy, cognitive behavioral therapy, acupuncture and other modalities.

Promote harm reduction at work. This may include installing a naloxone rescue station and posting signs telling employees where they can obtain information about naloxone and learn to recognize signs of overdose and be trained to administer naloxone.

Reduce stigma associated with pain, drug use, harm reduction and treatment. Treat all employees with compassion and dignity. Dispel myths about substance-use disorders, opioid therapy, naloxone and promote fact and evidence-based harm-reduction information.

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The Drug Enforcement Administration (DEA) has also initiated a new effort called “Operation Engage” that aims to bring together multiple stakeholders—including employers—to focus on ending the drug overdose epidemic.

The initiative encourages collaboration with health professionals plus community and social service organizations to shape work environments, provide health insurance coverage and influence local education and public safety policies.

The DEA is partnering with the Milken Institute Center for Public Health in this effort to connect with employers to reinforce drug prevention messages while supporting employees who need treatment and those who are in recovery.

The AMA created the issue brief to help support the Milken Institute and highlight the need to eliminate stigma in the workplace related to substance use and mental health and remove barriers to treatment.

Science, evidence and compassion must continue to guide patient care and policy change as the nation’s opioid epidemic evolves into a more dangerous and complicated illicit drug overdose epidemic. Learn more at the AMA’s End the Epidemic website.