Must-Do Strategies: Prioritize Support for Substance Use Disorders

The following article was originally posted on the?Mercer US Health News blog .?You can find this article along with more health news content?here .

By Tracy Watts, Senior Partner, National Leader for U.S. Health Policy and Mary Kay O'Neill, Partner, Clinical Services Consultant

The worst of the pandemic may be behind us, but its impact on behavioral health is ongoing. Stress, worry, and burnout caused many people to turn to unhealthy coping strategies, and the?incidence ?of substance use disorders has risen markedly. On the bright side, we learned a few lessons during the pandemic that can help us do a better job of helping patients with substance abuse disorders going forward.

New best practice for medication-assisted treatment

One important learning is about medication-assisted treatment. As the pandemic disrupted or shut down in-person care facilities, regulations were modified to allow doctors more latitude in prescribing substances to keep people stable. For example, a patient could receive a prescription for Suboxone (a medication for opioid use disorders) based on a virtual visit. And where methodone had been dispensed in one-day doses, patients could now receive a week’s worth. The old, more restrictive regulations had prioritized safety, but recent data shows that these new practices are both effective and safe, as well as much more convenient for patients. Further, it allows for better use of limited resources, especially in rural areas of the country where it’s not easy to find the right provider sitting in an office.

More openness about behavioral health and substance abuse diagnoses

The pandemic also taught us to be more open about mental health issues. Employers quickly learned that the only way to help employees cope with their anxiety and stress was first to acknowledge it.?They are changing their approach to substance use disorders as well. Where once the standard response was to issue a pink slip, today employers are more likely to provide support through employment-based treatment programs. Drug-free workplace programs help chip away at long-held beliefs that substance use problems must be hidden at all costs. They also provide a structure to continually promote the resources that are available to employees who need help for themselves or for a partner or young adult dependent.

One reason that reducing stigma and promoting open communication is so important is that employees are less likely to go off on their own and make poor choices – such as selecting a high-cost out-of-network treatment facility that is skilled at marketing but not at providing quality care. Steering employees who need inpatient or residential care to a high-quality network facility or center of excellence is likely to save them considerable money and produce better outcomes. One aspect of a high-quality treatment program is careful discharge planning that includes longer-term recovery support as the individual navigates the return to family, work and community.

The value of peer support

Peer support ?is a newer approach that bears consideration. While SUD benefits and programs typically focus on the treatment phase, an individual who has completed treatment will likely need good support for the next six months or even for a couple of years. Many innovative organizations that provide evaluation and treatment for SUD also provide virtual access to peer support. People can reach out to peer coaches by text or phone if they are having difficulties without having to wait for their next clinical appointment to discuss what may be a pressing issue. Peer support coaches typically have had their own experience with SUD and so can relate to what people are dealing with. Because they work as part of the larger treatment team, they can reach out to clinical personnel when that is appropriate.

The challenge for employers is to engage employees with substance use disorders at earlier stages, when their needs are less complex and easier to treat. Take stock of the programs and resources you have available today both at the worksite and through your health plans. Are there any gaps in the full continuum of care? A comprehensive program will emphasize education and prevention – such as training people to use healthy coping mechanisms – and provide programming for early treatment and centers of excellence for higher levels of care. Be sure to explore virtual programs that can provide or enhance support and access along the entire care continuum.

This blog post elaborates on one of the six “must-do” strategies Tracy Watts shared in her post,?2023: The Year to Get Creative with Strategic Planning . Check out the other articles in this series:?Optimize Benefit Spend and Minimize Cost Shifting ?and?All Paths Lead to Value-Based Care .