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employee substance use disorder can help employers improve productivity, reduce workplace injuries, and decrease health care costs (National Business Group on Health, nd). Employers can reduce substance use disorder by implementing: • Pre-employment drug testing Material Protected by Copyright • For cause drug testing • A drug-free workplace • Written substance abuse policies • Offering comprehensive insurance coverage for substance use disorders, including treatment, aftercare, and counseling • Educating employees about substance use disorder • Employee Assistance Programs and Work/Life programs • Reducing the stigma of substance use disorder o Helping employees obtain treatment without fear of losing their job o Return to practice guidelines • Surveillance systems to detect drug diversion (National Business Group on Health, ND) Did You Know? Research shows that 47% of men and 41% of women in need of treatment for illicit drug abuse are not treated. This unmet need is not limited to the uninsured—one study showed that almost half of individuals in need of substance abuse treatment had private insurance (National Business Group on Health, ND). Test Your Knowledge Research shows that almost half of workers needing treatment for substance use disorder, did not get help because they did not have health insurance. A. True B. False Rationale: Research shows that 47% of men and 41% of women in need of treatment for illicit drug abuse are not treated. This unmet need is not limited to the uninsured—one study showed that almost half of individuals in need of substance abuse treatment had private insurance (National Business Group on Health, ND). Treating Impairment Addiction is a treatable, chronic disease that can be managed successfully. Research shows that combining behavioral therapy with medications, where available, is the best way to ensure success for most patients. Treatment approaches must be tailored to address each patient’s drug use patterns and drug-related medical, psychiatric, and social problems. The chronic nature of addiction means that relapsing to drug use is not only possible but also likely. Relapse rates are like those for other well-characterized chronic medical illnesses such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply imbedded behaviors. For the addicted patient, lapses back to drug use indicate that treatment needs to be reinstated or adjusted, or that alternate treatment is needed. (NIDA 2016) The Center for Substance Abuse Treatment (CSAT) defines treatment as “in or out-patient services that focus on initiating and maintaining an individual’s recovery from alcohol or drug abuse and on preventing relapse.” (National Business Group on Health, ND). Did You Know? Material Protected by Copyright Individuals who receive treatment for addiction have: better long-term outcomes, improved long-term health, reduced relapse, and improved family and other relationships. Optimal Treatment Settings and Duration It is imperative that substance use disorder treatment be individualized and treated as a chronic disorder rather than an acute disease. Individuals with more severe substance use disorder typically have better outcomes when they enroll in more intensive treatment programs. Those who are relatively stable and/or have less severe addictions may not need these higher-intensity programs A typical course of treatment should include: • Detoxification - a medical procedure to reduce the physical effects of withdrawal from substances • Acute Care - consisting of behavioral and medication-assisted therapies • Maintenance or Continuing Care Research shows that for either residential or outpatient treatment, lengths of less than 90 days are of little or no effectiveness. In general, better outcomes are typically associated with outpatient treatment lengths that are greater than 90 days. Although, persons with more severe or multiple problems may need a longer duration. To maximize the likelihood that the employee will remain abstinent, treatment for addiction must be of sufficient duration and intensity. Some examples
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