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Prepare for substance abuse issues after lockdown: Experts

substance abuse

Surging alcohol and marijuana sales and a lack of access to traditional support networks during the pandemic could lead to a number of individuals returning to the workplace with substance abuse issues, experts say.

 “Whenever we have a traumatic situation like COVID-19, people often fall back on maladaptive behaviors,” said Perry Halkitis, dean and public health psychologist at the Rutgers School of Public Health in Piscataway, New Jersey. “Many people — especially during crises — turn to various substances to ameliorate the stresses and emotions they are experiencing.”

The data on stress, anxiety and depression confirms an upward trend. The percentage of individuals who sought screening for anxiety and depression in May were 370% and 394% higher, respectively,  than in January, reported Mental Health America, a nonprofit that promotes mental health in the U.S. Americans today are more stressed than they have been since the Great Recession of 2007, according to the American Psychological Association’s May report.

Data also shows that many are turning to substances – both legal and illegal – to manage that stress, anxiety and depression.

Prescriptions in the U.S. for anti-anxiety medications and antidepressants, rose 10.2% and 9.2%, respectively, in March, compared with March 2019, according to health-research firm IQVIA Holdings Inc. Sales of alcoholic beverages in March were up 55%, compared with March 2019, according to marketing research firm The Nielsen Co., and at least one state with legalized marijuana – Washington – reported record sales during the pandemic.

Multiple states have also reported spikes in their numbers of opioid overdoses and deaths, the American Medical Association reported in a research brief on June 8.

Noting the trend, the National Safety Council released a statement this month urging employers to brace for increases in worker substance misuse. The safety organization also encourages employers to implement substance abuse policies and procedures as part of their return-to-work strategy.

“People are using more substances, drinking more during the quarantine. … This is unprecedented,” said Rachael Cooper, senior program manager with the National Safety Council in Itasca, Illinois. “We don’t know what will transfer back to the workplace. Just because somebody goes back to work doesn’t mean everything they’ve experienced (during the lockdown) goes away.”

The pandemic’s shelter-in-place orders have “pushed individuals battling sobriety into isolation and have decreased access to treatment and opportunity for distraction from addictions,” which could cause a surge in substance misuse relapses and a “surge of opioid abuse,” the American Journal of Managed Care said in early June.

For people with pre-existing substance use issues, events like the pandemic can “be very triggering, and we’re very concerned for relapse,” said Vaile Wright, senior director for health care innovation at the American Psychological Association.

Just before the lockdowns went into effect, many pharmacy benefit managers lifted their restrictions on highly controlled drugs like opioids and benzodiazepines, which allowed some workers to refill those prescriptions sooner than usual, causing some concern for potential abuse, said Dr. Teresa Bartlett, Troy, Michigan-based senior vice president of medical quality for third-party administrator Sedgwick Claims Management Services Inc.

“A lot of people did turn to alcohol and drugs,” she said. “I think there will be a lot of unintended consequences (of the pandemic) … A lot of them we haven’t yet seen.”

Bringing workers back into the workplace is going to be challenging for employers, Mr. Halkitis said.

“People need to be eased back into the work routine — people will have been drinking and eating and not exercising,” he said. “You can’t just rip the (bandage) off.”

To better manage the issue, employers can check in with employees regularly and make sure they are aware of the benefits and resources — such as an employee assistance program and mental health benefits — that may be available to them, Dr. Bartlett said.

“We can’t be doing enough of that while people are working from home,” she said.

Employees are in a vulnerable place and there is a lot of stigma associated with mental health and substance use, Ms. Cooper said.

“It’s important to know how to link (workers) to the appropriate people for support,” she said. Supervisors need to be trained on “how to have difficult conversations.”

More insurance and workers compensation news on the coronavirus crisis here.