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Parity, recession open doors for providers

April 15, 2010
by Dennis Grantham, Senior Editor
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Hazleden’s Poznanovich says providers’ expertise could fill gap for corporate employers

BH: Are you seeing any reluctance on the part of America’s corporations to dedicating resources to treat addicted employees during this prolonged recession?
RP: No, not specifically. The recession has caused companies to look at ways to cut costs and one area that continues to get a lot of attention is healthcare. Businesses want to motivate people to stay healthy and, for those who are sick, to recover at a higher rate. We’re also hearing a lot of different strategies around mental health parity and how companies are changing employee access to treatment so they legally meet the new federal requirements. New gatekeepers are emerging and that will be an interesting trend for treatment providers to recognize.

BH: In your view, does this situation present an opportunity or a hurdle for treatment providers?
RP: Both. The untapped opportunity is when corporations realize that addiction is the chronic illness that it is. They've already invested significantly in wellness and disease management programs for other chronic conditions like diabetes and heart disease. They've already made huge cultural changes around smoking. But most haven’t included addiction in their wellness programs. They haven’t deployed disease management strategies to help those with addiction recover at a higher rate, and they haven’t thought to establish relationships with treatment providers so that they have some control over the quality of treatment their employees get—especially now that the legal controls are off benefit limitations.

The hurdle is that there is still a cultural attitude that addiction is a disease born out of choice. The stigma is still there. What’s more, corporations may be misreading data from their EAPs that suggests there is no problem because very few people use their EAP to access treatment. A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that for employees with employer-sponsored health plans, only 3.2 percent of treatment center referrals come from an employer’s EAP. Yet data shows that most people who are addicted are employed. Seventy-six percent of illicit drug users are employed either part- or full-time; of the 12.4 million heavy drinkers in our country, 80 percent are employed. Despite these statistics, many companies still believe they do not have a problem. BH: You were once one of the 76 percent of illicit drug users who was employed—and at a very high-level job. Did your employer address your addiction, and was it effective?
RP: My former employer is an example of a company that didn’t know what to do about addiction. I was a corporate executive for a Fortune 200 company—in charge of sales for a billion-dollar division with a $300 million personal team goal. Clearly, I had an impact on that corporation's success as well as the stress levels of those below me.

In the end, I was using about $500 worth of cocaine a day. I heard subsequently that there were 50 meetings about me, but never a meeting with me. The only meeting they had with me was the one during which I was fired. The company president pulled me aside and said he thought they were making a mistake in letting me go. The reality was the mistake was made much earlier, because if they had approached me and told me that they knew about my drug problem, I would have run to get help. As it was, I was in denial. I wasn’t willing to step up and say I needed help because I didn’t know what that would do for me, and I was afraid of what the consequences would be.
I’m in recovery now. And maybe my story can be considered an extreme case. But you can’t ignore that 12 percent of the population needs treatment. The majority of those people hold jobs, and many of those have access to EAPs but are not using that resource for fear about retribution. That’s because of the stigma. BH: How can treatment providers help educate corporate America?
RP: Corporations are not a market that our industry has targeted actively. To do so, we have to appeal to their bottom line because I don’t think corporations have a handle on the true costs on a per-employee basis. Addicted employees incur three times as many healthcare costs, five times more workers' compensation claims, and significantly more lost workdays per year than other employees. A study at Steelcase Corp. by the University of Michigan determined that the healthcare cost for every Steelcase employee with a heavy drinking problem was twice as high as that of a smoker.

Unlike other chronic diseases, however, the cost of addiction doesn’t stop there. There are also the costs of lost productivity, lower quality work, and higher risk for workplace violence, accidents, harassment, and presenteeism to consider. I usually summarize it by saying addicted employees are twice as expensive and half as productive.
The other component we need to help businesses assess is the employee’s dependents—those individuals who live with an employee and who may be addicted themselves—and what their cost-impact is in terms of stress and productivity on the employee. And, if those dependents are covered by the employer’s healthcare plan, what the healthcare costs are to the company.

BH: With what you just said, why shouldn’t an employer just fire an addicted employee?
RP: You can't fire an employee because of alcoholism or drug addiction—there are some protections under the Disabilities Act. However, you can fire somebody for lack of production. As a solution, though, firing is expensive and is a reactive response rather than a proactive one. The problem occurs before an employee reaches the point of being fired so the solution needs to occur there, too. The solution lies in the answer to the question: How does an employer create an environment where people have the ability to get help earlier in the addiction process?