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The High Cost of the Opioid Epidemic

OneDigital is invested in strategically assisting our clients with getting the most value from their employee benefits offerings.

We help clients gain claims visibility, understand key cost drivers and create outcomes based solutions to fit their unique needs. In today’s environment, a staggering number of claims can be tied back to the opioid epidemic. The Center for Disease Control (CDC) estimates that the “economic burden” of opioid misuse in the U.S. is $78 billion per year when factoring in addiction treatment, the cost of healthcare and lost productivity. It’s an incredibly complex problem and according to a CDC report by Kantor and Gladden, overdoses increased 30% from July 2016 through September 2017, in 52 areas in 45 states.

The opioid epidemic is fueled by a misuse of prescription pain relievers, heroin and synthetic opioids such as fentanyl, hydrocodone, oxycodone, morphine and codeine. Highly addicting in nature, repeated misuse causes changes in the brain and the development of a substance use disorder (SUD) which can lead to health problems and the inability to meet responsibilities at work, school or home. This crisis is disproportionately impacting employer-sponsored health plans.

The tragic outcome of this vicious opioid addiction recently hit home for me when good friends lost their son to an overdose just a few months ago. Their son had been struggling to shake the addiction for years. After months of improvement and holding a steady job, he relapsed, which ultimately cost him his life. The torture and pain caused by his lengthy addiction and subsequent death have changed the family forever. This horror is happening in neighborhoods everywhere and now even states and the federal government are attempting to ramp up awareness, attention and funding to reverse the staggering trend.

Aside from the state and federal commitments to address the problem, the healthcare system certainly needs to improve its response. Here are just a few of the best practices that are unfolding as a result of the crisis:

  • Medical, dental and facility providers need to follow much tighter rules for dispensing of opioids and proper dosing limits as prescribed by the CDC and CMS
  • Providers should be identifying at-risk patients who are more inclined to become addicted due to depression or other post-trauma disorders
  • Be proactive in educating patients of the dangers associated with first-time use of opioids
  • Reinforce special fraud detection processes to stop those providers who are not complying with new dispensing protocols

The misuse and abuse of prescription opioids is a growing concern for large employers. It impacts employee productivity, workplace costs, absenteeism and disability costs, workers compensation claims, and overall medical expenses. At the same time, behavioral health is an increasing area of focus among employers and companies are making attempts to improve access and reduce the stigma associated with behavioral health treatment, including addiction. To help employers navigate this crisis our three part blog series will highlight ways for employers to effectively combat the opioid epidemic, while keeping the employee journey top of mind.

Make sure to visit the OneDigital Fresh Thinking Blog for the latest on industry trends and fresh-thinking solutions and to speak with a consultant directly about the opioid epidemic, reach out to your OneDigital representative.