By: Philip Qualo, J.D. Life as we know it came to a halt in February of last year due to the quick and vicious spread of the COVID-19 virus. Although the US has made significant strides in slowing the spread, and pharmaceutical companies have manufactured vaccines, employees across the country continue to struggle with the realities of working from home. Whether due to stress associated with juggling work and family within an eight-hour workday at the kitchen table, or the inherent loneliness of performing job functions without peers or colleagues to interact with, working remotely and isolation orders have taken a toll on the American psyche. COVID-19 continues to be an uncertain, ever-evolving reality, and its impacts are particularly being felt among those with addiction and those in recovery from substance use disorders. As a result, health plans are already experiencing an influx of costly claims associated with substance abuse. In order to combat the spread of the virus, the government, the media, and even our employers have told us “stay at home”. The bars and restaurants we frequented are all shut down, or only accessible via curbside pickup. Although these orders are intended to enhance public and workplace safety, complying with these orders has presented unique challenges for people with substance use disorders and in recovery. The stress from social isolation and other COVID-19 related life changes can lead to or worsen substance use and abuse. Widespread shutdowns and social distancing mandates have made it difficult for those seeking guidance and treatment for substance abuse issues to secure resources. Because of this, the US has experienced a surge in alcohol sales and drug addiction relapses as substance abuse becomes more prominent. In the 12 months prior to May 2020, the US recorded 81,230 drug overdose deaths, an 18.2% increase over the previous 12-month period, according to the Centers for Disease Control and Prevention . The CDC announced this past December that overdose deaths had already accelerated in the months before COVID-19 came to the U.S., but had sped up even more during the pandemic. The rationale is before the pandemic; employees didn’t have much opportunity to do drugs or drink while working in an office location. With remote work, they are even more isolated from society and nobody is around to see them drinking or taking drugs. It is common knowledge that substance abuse costs employers a lot of money every year in the form of healthcare treatments and missed work. These costs are dramatically increasing, however, due to the inevitable feelings of isolation and despair inherent in isolation that can lead to substance abuse disorders. More importantly, there are also health risks resulting from chronic substance abuse as it weakens the immune system and puts stress on the body’s cardiovascular and respiratory systems. All of these factors combined equal a rapidly escalating and expensive problem for employer-sponsored health plans. This is especially troubling as health plan expenditures are already expected to rise in 2021 due to Americans foregoing preventive care in 2020 out of fear of catching the virus in healthcare settings. There is no question that social distancing and stay-at-home orders are a necessity at this time due to soaring infection rates. It is important, however, to keep sight of the larger picture when assessing the toll of this pandemic on Americans and our health plans that goes far beyond the illness itself. COVID-19 has dropped a grenade on our efforts to combat substance abuse disorders, and as a result, health plans can expect to carry the hefty price tag. Some strategies plan sponsors may want to consider to reduce the impact on their own workforce is to offer programs to help plan participants overcome and prevent substance abuse. These programs may include an employee assistance program, narcotics therapy management programs, and designated centers of excellence for substance use.