Closing the Divide in Substance Use Care with Specialized Treatment

The 2023 Pelago Annual State of Substance Use Management Trend Report revealed a startling reality: despite 62% of workers believing their employers should offer dedicated support for substance or alcohol use management, only 17% reported having access to such benefits. This divide signifies a missed opportunity, leaving thousands of dollars per employee in medical costs and productivity issues unaddressed.

Today’s benefits leaders must grapple with aligning benefits choices with workforce well-being. As economic uncertainty and the focus on cost savings intensifies, the surge in substance use disorders (SUDs) poses a significant — yet manageable — challenge.  However, by analyzing medical claims data and taking a strategic approach to SUDs with the right level of care, organizations can position themselves and their employees for financial and well-being success in 2024.

Mental Health and Substance Use: One Size Does Not Fit All

Mental health programs clearly have their place and are an essential part of an organization’s benefits offering. The challenge in managing mental health and substance use disorders lies in the blurred lines between the two. Often, employers address substance use benefits through a mental health first approach or through employee assistance programs (EAPs). However, this approach to SUD treatment often leaves a significant treatment gap.

Currently, there are about 49 million working U.S. adults with a substance use disorder, mental illness, or both (co-occurring disorders). And of those 49 million, more than half (55%) are in need of a dedicated, substance use first, program. With a behavioral health strategy that only addresses mental illness, less than half (45%) of employees’ true needs are being addressed.

The Economic Impact of Neglecting Substance Use Management

A behavioral health approach without a dedicated substance use management program may also come with a hefty price tag. A 2023 CDC economic analysis puts the minimum annual direct cost of SUDs at $15,640 per affected employee enrolled in employer-sponsored health insurance, totaling more than $35 billion. This does not include indirect costs related to absenteeism, presenteeism, and turnover or the costly health consequences and complications of underlying, undiagnosed SUDs.

These high-cost substance use disorders are driving medical spend, leaving costly gaps in behavioral health care benefits. That’s why a behavioral health strategy absent substance use management is an incomplete strategy that has proven inadequate.

The Power of Dedicated Substance Use Management 

A dedicated substance use management program is designed to address substance use issues specifically, whereas mental health first programs and EAPs tend to have a broader focus. A dedicated substance use management approach can lead to more effective prevention, early intervention, and treatment of substance misuse. The result is improved health outcomes, saved lives, and financial savings.

Pelago recently demonstrated annual per member medical cost savings of $9,367, including $7,783 in physical health savings, with a 3x ROI. This marked the first ever ROI study conducted on the impact of a substance use management program in an employer population across multiple clients with a large sample size.

Pelago’s success in SUD treatment hinges on three critical outcome drivers: proper assessment through a digital SUD front door, certified high-quality care with validated outcomes, and SUD medication access for opioids, alcohol, and nicotine. Pelago’s unique approach guarantees accessibility, performance, and outcomes, making it a pioneer in the substance use management category.

Three drivers of a successful dedicated SUD-first program

1. Proper Assessment via a digital SUD front door
2. Care Quality with certified high-quality care and validated outcomes
3. SUD Medication Access for opioid, alcohol, and nicotine, including MAT for adolescent opioid use (starting at age 16)

The lack of dedicated substance use management programs in organizations leads to untreated SUDs, resulting in escalating healthcare costs and poorer outcomes. Pelago’s solution can help organizations bridge this divide. Our program provides a superior care model, including specialized substance use treatment, standardized practices, treatment continuity, adult and adolescent care and support, and counselor-provider collaboration.

To learn more about how your workplace benefits or health plan team can best support employees and members, including adolescents, contact a solutions expert today