The COVID-19 pandemic may have worsened the crisis
During a year that was like no other, the pandemic likely exacerbated the crisis based on these reasons:
- Social isolation unexpectedly upended many individuals’ recovery support.
- Long-standing substance use disorder support meetings had to shut down and many treatment programs went remote.
- The isolation, fear, and anxiety that people experienced from March 2020 forward resulted in increased substance use to cope with those feelings. People in recovery were impacted even more profoundly than those without a history of substance use disorder.
Stigma is the main reason for a continuing crisis
The National Institute on Drug Abuse defines addiction as a treatable medical condition, but it is often considered by the public to be a weakness, character defect, and sign of social deviance. The institute notes that this is even true within healthcare systems, leading to the inability for some people to get proper care.7
In 2017, a Johns Hopkins survey asked people, “Are individuals who are addicted to prescription opioids to blame for the problem?” Seventy-eight percent answered yes. 8
The opioid substance use crisis didn’t happen overnight; it originated in the 1990s
When discussing combatting stigma and the continued crisis, it’s also important to examine the history of the crisis. In 2020, Prudential released research on the connection between chronic pain and opioid dependence. We stated that the pharmaceutical companies pushed opioids as a safe pain management solution in the 1990s, assuring physicians that addiction would not be an issue. As physicians wrote more opioid prescriptions, their patient satisfaction scores relative to pain management in the hospital increased, too. Unfortunately, addiction rates subsequently rose after hospital discharge.9
Fentanyl, the semi-synthetic opioid, also emerged in the 1990s. Fentanyl was used in the 1950s and 1960s as a miracle pain medication. Because the drug is up to 300 times more potent than morphine, it was designed as a last resort for terminal patients in severe pain that couldn’t be managed with less potent drugs. Fentanyl is essentially legal heroin, gaining popularity in the 1990s as a more mainstream pain treatment.10 It’s highly addictive but cheaper to make than heroin. As a result, street heroin is often cut with Fentanyl. Drugs sold as OxyContin are sometimes actually Fentanyl. Because the lethal dose for Fentanyl is only .002 grams, it’s often the culprit in unexpected overdoses.11
Employers can consider options to help employees struggling with substance use
- Ensure there’s chronic pain/surgery support for employees to reduce opioid use/abuse risk.
- Incorporate substance use disorder into campaigns to reduce mental health stigma.
- Encourage leaders to share their experiences with substance use disorder.
- Educate managers on the signs of emerging substance use disorder and equip them to make referrals for care.
- Examine your health plan benefits to make sure they cover substance use disorder treatment.
- Work with your Employee Assistance Program to offer resources for those seeking support groups/treatment.
- Ensure the workplace health plan requires evidence-based treatment protocols for substance use disorder
- Provide transitional return-to-work options for those reintegrating to the workplace after treatment.
A key to an employer’s understanding is that substance use disorder is a chronic, relapsing, and remitting disease. The National Institute on Drug Abuse concludes that a common mistake in addressing the crisis is that we often only care for those who are drug-free. To reduce the overdose rate, the institute states, we must offer care and compassion to those still using and those who are amid a relapse.12