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Addressing substance misuse in the workplace: A real-world case study



Substance use disorders affect a substantial portion of American society and its workforce. The Substance Abuse and Mental Health Services Administration (SAMHSA) 2021 national survey results report 46 million Americans living with a clinically diagnosable substance use disorder (SUD). 

A staggering 75% of individuals struggling with a substance use disorder are currently employed and open to treatment. Unfortunately, due to limited access and high costs, fewer than 10% of these individuals receive the help they need. Industries such as manufacturing, retail and logistics, where safety is paramount, are particularly susceptible to the negative consequences of SUDs. 

As revealed in the Pelago 2023 Annual Substance Use Management Survey, 1 in 6 U.S. workers report missing work because of a personal substance or alcohol use problem. When factoring in workers impacted by a family member’s substance use problem, we find that nearly half of all workers are affected by a substance use disorder (SUD). 

Add in the growing direct and indirect costs of substance use disorders highlighted in new CDC data  –  which puts the annual minimum cost of substance use disorders at $15,640 per affected employee totaling more than $35 billion – and the scope and cost of the substance use management challenge becomes clear. 

Understanding the unique role and responsibility employers have in managing substance use issues, a major U.S. health technology company approached Pelago to help address the impact that SUDs were having on both employee well-being and healthcare costs. The company successfully partnered with Pelago to decrease alcohol use, improve mental health and generate a powerful return on investment among its more than 20,000 employees. 

The multifaceted impact of substance misuse

Substance misuse is closely associated with co-morbidities and other chronic conditions. Often hidden in heart and liver disease, osteoporosis, MSK, diabetes, cancer, chronic kidney disease and mental health conditions, SUDs lead to annually compounding healthcare costs. And, as the CDC study pointed out, the hard medical costs do not include business impacts related to absenteeism, presenteeism and turnover.  

It’s also estimated that about 80 million Americans engage in risky substance use behaviors. These individuals often maintain a high level of functionality, making it difficult to identify the problem. For example, 50% of individuals with severe mental health illnesses also have co-occurring substance use disorders

The Pelago substance use management program aimed to improve access to care, reduce stigma, improve health and happiness and decrease healthcare claims. With an emphasis on alcohol use, the company’s members engaged with Pelago’s physician-led care team, consisting of nationwide physicians and nurse practitioners as well as dedicated drug and alcohol counselors. Members were able to take advantage of telehealth consultations and psychological support, along with discreet prescription fulfillment and remote monitoring devices.

Program results and outcomes

Since its launch of the Pelago program, the company has seen an impressive 85% utilization rate among registered members. These members have benefited from an average of 46 care team interactions, surpassing industry benchmarks. Furthermore, the program’s content engagement has demonstrated positive results, with members completing an average of 10 steps tailored to their individual triggers.

After just 60 days of Pelago care, the company was able to report impressive outcomes, including a 76% reduction in heavy drinking days and a 50% reduction in risk factors for problem drinking compared to industry benchmarks. 

The positive trajectory continued after three months, with participants reporting:

  • An average 18 days of alcohol abstinence in the past 30 days compared to just over 11 days prior to treatment entry
  • That confidence in achieving complete abstinence increased by 60%, and alcohol craving decreased by 36% during the same period
  • The number of heavy drinking days decreased by 54%, accompanied by a 47% decrease in psychological problems and a 53% decrease in troubled sleep patterns

The value of substance use management

This top 10 health technology company’s partnership with Pelago for substance use management demonstrates the value of addressing substance misuse in the workplace. By implementing a comprehensive care program, the company achieved significant improvements in alcohol use, mental health and overall well-being among its employees. 

Effective substance use management that engages the workforce leads to an understanding of the impacts of substance use on one’s body and managing that use to a healthy state. This case study demonstrates the power of efforts to combat substance misuse in the workplace and underscores the importance of providing accessible, quality treatment for substance use disorders – not only for the individuals affected but also for the financial health of organizations.

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