Hitting Reverse on the Opioid Epidemic

Amid an opioid epidemic that has infiltrated every corner of our country, cutting across income levels and professions, the time has come for employers to do our part to save lives.

My not-for-profit health insurance company is engaging in this key frontier: We are launching a pilot program to provide opioid-reversing “toolkits” directly to employers. The idea is simple: Keep this life-saving tool on the job, just as defibrillators are available for heart attack victims in many public spaces.

Our kits contain two nasal spray doses of the opioid antidote naloxone along with a surgical mask, gloves and instructions on how to administer the drug. Those instructions fit on an index card: “Call 911. Peel the sealed Narcan package open. Place your thumb on the plunger of the small container. Insert the nozzle in the nose of the unconscious person and spray.”

Under our pilot program, we will distribute hundreds of these $130 kits — a small price to save a human life.

It also happens to be a fraction of the cost many businesses are facing in opioid-related injuries, accidents and absenteeism.

Yet many employers struggle to address this emergency. The stigma around substance use remains as virulent at work as it does in the rest of society. Admitting one of your workers could overdose at a desk or a construction site or a factory floor — that takes rare candor, even bravery.

Among the pilot accounts for our opioid toolkit program are one of Massachusetts’ largest construction companies, Shawmut Construction, one of the largest unions in our state, the New England Regional Council of Carpenters, as well as two of our municipalities, the City of Brockton and the town of Ware. They have that rare courage, and empathy, too.

Their employees are often on the front lines in neighborhoods where addiction has hit home. They are eager to raise awareness about prevention and intervention, eager to be empowered to respond to overdoses.

That is not to say that keeping Naloxone available in the office is a simple decision. As an employer, I know firsthand how hard it is to admit substance use may have pervaded a workplace. I don’t like to think even one of our 3,700 employees could be struggling with an addiction to opioids. But I also know this plague spares no one – no state, no neighborhood, no company. So we will be stocking the Narcan toolkits in our Blue Cross buildings, too.

Employees are ready for this step: A survey Anderson Robbins Research conducted for our company last month found 70 percent of people in Massachusetts believe Narcan should be stocked at work.

It’s time to engage in candid conversations about substance use at work, the same way we can talk about heart attacks or diabetes or, at long last, HIV. It’s time to end the corrosive stigma around addiction.

That’s why our company is also providing employee education and training for our pilot accounts, including an online opioid resource center that will offer information on medication safety, pain management and treatment options. Partnering with the Massachusetts Department of Public Health, we will provide an expert in naloxone administration so the participating employers can train their own in-house trainers.

For a health plan to distribute Narcan may strike some as pushing the health care envelope. Shouldn’t we focus on prevention and treatment? To be sure, we do.

Our company in 2012 implemented guidelines for the appropriate prescribing of opioid-based medication. Since then, our state has seen a reduction in prescriptions for these painkillers by an estimated 60 million doses. Our program became a model. We have expanded treatment options and reduced barriers to care. Our state, like many others, makes naloxone available at any pharmacy with or without a prescription, and our company has been eliminating the copay for naloxone for many of our members.

But as we take this step, it has occurred to me that we spend a lot of time in the insurance field thinking about the root causes of the opioid crisis. We think about our own practices, the practices of physicians and pharmaceutical companies, and the practices of policymakers. And we make smart changes to address those root causes.

And yet, a quarter of residents in my state, my neighbors, know someone who has fatally overdosed.

Last year, in newspapers in every community in America, there were 49,000 heartbreaking obituaries for people who overdosed on opioids. Narcan, administered swiftly, could have reversed many of those overdoses.

Thinking about root causes is important. Taking action to address those root causes, action at health plans and pharmaceutical companies, in statehouses and on Capitol Hill, in schools and doctors’ offices and living rooms — that’s crucial.

But it’s not enough.

It’s time for all of us to think of ourselves as first responders.

It’s time to save lives on the job.


Andrew Dreyfus is president and CEO of Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer with 2.8 million members.

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