By David Pawlowski, LCPC, CEAP, SAP, DCC
For decades, employee assistance programs (EAPs) have offered a low-barrier, confidential way for employees to seek help quickly – before a small problem becomes a larger and costlier one. Unfortunately, in the case of opioid abuse and pain pill addition, the problem often reaches a crisis level in a matter of days or weeks, as opposed to the months or years it typically takes for other common problems like alcohol abuse to reach the same level of severity. While EAPs can play a vital role in helping employers address the problem of opioid abuse, in order to truly be effective, the program must be built and positioned in a very specific way:
Position the EAP as the entry-point for all MHSA services. To the fullest extent possible, guide all employees to the EAP for any issue related to mental health or substance use. Employees with an opioid abuse problem require a significant level of advocacy and support. Consider putting the phone number for the EAP on the insurance card, with guidance language that steers all employees seeking help for a mental health or substance abuse problem to the EAP first. Similarly, ensure that customer service representatives, benefits specialists and any other internal or external health plan experts or advocates your employees may have contact with are trained to refer employees to the EAP for assistance with a mental health or substance use problem. The EAP should spearhead and deliver this external training initiative.
Ensure all calls into the program are answered live 24/7/365 by a licensed, experienced clinician. When an employee with an opioid abuse problem calls the EAP, the first person he or she speaks with must be an expert. With opioid abuse, problems escalate quickly and crises are not uncommon. In most cases, the window of opportunity when someone with an opioid addiction is open and receptive to help is very small. An experienced clinician can reinforce the positive steps an employee is taking and use evidence-based strategies such as Motivational Interviewing (MI) and Screening, Brief Intervention and Referral to Treatment (SBIRT) to enhance motivation to change and increase the likelihood that the employee will follow through with treatment.
Confirm that the EAP conducts a comprehensive mental health and substance abuse assessment for every participant at the point of entry. Stigma is real, and employees often minimize their problems. A comprehensive clinical assessment that includes the administration of evidence-based screening tools will ensure that no underlying issues are missed. Then, based on the assessment, the EAP clinician can work collaboratively with the employee to develop the most clinically-appropriate care path – and provide guidance and steerage to the highest-quality and most cost-effective in-network treatment options. By ensuring employees always receive referrals to the ‘right’ providers and facilities, the EAP can have significant and measurable impact on health care costs.
Fully integrate the EAP with the MHSA component of the employee medical plan. Unlike most other common EAP presenting concerns like relationship problems, stress and lower-grade depression that can often be resolved through short-term counseling, opioid abuse or addiction will likely require longer-term and highly-structured treatment plan, utilizing resources within the mental health and substance abuse (MHSA) component of medical plan. A variety of treatment options are available to battle opioid abuse, including detoxification, inpatient rehabilitation, outpatient behavioral health counseling and medication assisted treatment (MAT) – and, often times, the most effective solution is a combination of multiple treatment types. However, regardless of the recommended treatment plan, it’s important that the integration channel between the EAP and the medical management component (UM/CM) of the medical plan is sound. By ensuring a secure, warm hand-off from the EAP to medical management, the employee’s case continues to be managed appropriately – from start to finish. When addressing opioid addiction, the importance of ongoing case management at every stage of the treatment process cannot be overstated.
In addition to assisting employees who already have a problem, an EAP can also be an organizational resource to assist employers who wish to take a more proactive role in addressing issues related to employee opioid use and abuse. The following are just a few of the many ways that an EAP can support the organization:
Drug-Free Workplace Policy Development
Employee and Supervisor Education and Training (including ‘Reasonable Suspicion’ training)
Formal Management Referral (FMR) Services
DOT/SAP Services (for employees whose job duties fall under federal DOT regulations)
Whether an employee seeks help on his or her own, or the employer recognizes a problem and refers the employee in a more formal manner, an effective EAP can play a critical role in addressing and resolving opioid use disorders. However, in order to maximize the effectiveness that an EAP can have on opioid abuse within the workplace, the program needs to be positioned, marketed and integrated effectively.
This article was originally published in the August 2017 edition of Employee Benefit News.