August 31 is International Overdose Awareness Day. This day is marked by a global campaign to end overdose, memorialize without stigma, and acknowledge the grief of friends and family left behind. Over 841,000 people have died of an overdose since 1999, according to the Centers for Disease Control and Prevention (CDC). Drug overdoses jumped 30 percent in 2020 to 92,500, a spike that some experts say may have been exacerbated by the COVID-19 pandemic.
People in the United States are more likely to die from accidental opioid overdoses than in car crashes. According to a 2019 report from the National Safety Council, opioid overdoses are a leading cause of death behind heart disease, cancer, respiratory disease, and suicide. The sheer amount of data regarding overdose deaths in the United States make it clear that substance use is far from an uncommon phenomenon for most Americans — whether they themselves struggle with substance use or have a loved one that does.
Kristin Krivickas, a mental health clinician at Eden Health and a Licensed Clinical Social Worker and Certified Alcohol and Drug Counselor, outlined how therapy plays an integral role in the treatment of substance use and how HR teams can provide support for employees who may be struggling.
THERAPY AND SUBSTANCE USE TREATMENT
“There are so many different paths that lead to someone entering treatment,” Krivickas said. “And treatment outcomes really vary, whether someone has chosen treatment electively or whether it was legally mandated.”
There are a lot of theories about what causes addiction. Krivickas looks at the medical model of addiction, meaning that it’s a disease of the brain — it’s preventable, treatable, and has the potential to change one’s biology. “Substance use does not discriminate,” said Krivickas. “It doesn’t care how old you are, what your socioeconomic bracket is, or what your race or cultural background may be.”
Therapy will evolve based on a patient’s understanding and acknowledgment of their substance use as a problem, according to Krivickas:
- During a pre-contemplation stage, a therapist may use motivational interviewing techniques that are non-confrontative and involve active listening and non-blaming.
- During the contemplation phase, therapists may rely on a guided assessment of consequences of use to determine how an individual’s substance use has impacted their relationships, employment, or families.
- In the preparation phase, a therapist may help a patient work on figuring out what steps they need to take to make a change.
- The action phase is where the most work will come in — this is when a therapist can see that the patient has an active commitment to harm reduction or a relapse prevention plan and are committed to changing what has contributed to unsafe situations in the past.
- The maintenance phase tapers off to include less intensive therapy sessions, focuses on repairing relationships, and supports the step work of groups like Alcoholics or Narcotics Anonymous in therapy sessions.
HOW LOVED ONES CAN PROVIDE SUPPORT
First, it’s important to remember that, though our first impulse may be to try to talk about an emerging problem, it is likely that someone with an addictive illness will be resistant to attempts to engage in a conversation about their behaviors.
Here are some pointers loved ones can utilize when trying to discuss their concerns:
- Choose a time to bring up your concerns when your loved one is not actively using
- Anticipate some push back — they may try to normalize, deflect, deny, or minimize
- Express your observations in a non-confrontive, non-blaming way: Use I statements like “I’ve noticed you seem really irritable lately” or “I’m sad when you come home late and I don’t know where you are”
- Place limits on enabling behaviors — stop giving your loved one money, ignoring or minimizing their behavior, or making excuses for family and friends on their behalf
HOW HR TEAMS CAN PROVIDE WORKPLACE SUPPORT
While it’s unlikely that an employee with a substance use issue will reach out to HR directly for support, you should still know how to best support them if they do. “I would encourage the employee to look into their mental health and substance benefits on their insurance plan,” said Krivickas. “The plan may include access to benefits for confidential therapy, a variety of treatment options, or access to recovery specialists. It may also offer access to inpatient or outpatient treatment services, personalized coaching and support programs, and referrals to local community support groups, behavioral coaches, or online resources.”
When are HR teams more likely to notice a problem? Krivickas notes that co-workers may see behavior patterns emerge — chronic absenteeism, calling in sick, missing meetings, poor performance, or erratic and unusual behavior may all be signs that an employee is struggling.
For a “functional” substance user, the threat of losing employment or talking with their supervisor or HR about performance problems could, in fact, be a positive intervention that may lead to behavior change, even if substance use is not acknowledged by the employee.-Kristin Krivickas, mental health clinician at Eden Health
“In the case where there’s a report from a colleague about observed behaviors, my thought would be to discuss the issue directly with their supervisor so that a plan might be put in place to improve performance,” Krivickas advised. “If the behavior continues despite that intervention, HR may need to have protocols in place to help mediate.”
Want to learn more about how Eden’s mental health services can help support your employees? Request a demo with a member of our team.