Aetna and George Washington University Pilot Study Helps Identify and Support Risky Drinkers

Aetna (NYSE:AET) released the results of a pilot that showed alcohol screening combined with a motivational interviewing technique helped identify a significant number of individuals who periodically misuse alcohol. The pilot found the majority of risky drinkers were willing to engage in conversations about their alcohol use. According to Aetna Behavioral Health and George Washington University (GWU) steps can be taken to reduce hazardous behavior in these populations.

The results of the pilot, which were recently presented at the 2009 Behavioral Healthcare Payor Summit in Phoenix, Ariz. by Dr. W. Dennis Derr, Aetna Behavioral Health Employee Assistance Program (EAP) director, showed the Screening and Brief Intervention (SBI) technique it used was effective in identifying people with high, moderate and low levels of hazardous drinking behavior.

Aetna Behavioral Health’s Employee Assistance Program (EAP) clinicians screened almost 300 employees at a global corporation by telephone as part of its normal EAP clinical intake process. Researchers found up to 40 percent of employees prescreened positive for potential risk. Fifty two percent of those with a positive prescreen were found to have moderate to high risk behaviors. Almost 80 percent of those offered follow up agreed to future discussions about their EAP services and needs including their alcohol use.

"The findings in this pilot show us that there may be a way to decrease the toll risky drinking takes on people, their families and their employers,” said Louise Murphy, head of Aetna Behavioral Health. "Government reports have shown risky alcohol users cost employers twice as much as their healthy counterparts. This is potentially due to increased accidents and emergency room visits, missed work days and lack of productivity on the job. In fact, risky drinkers use almost twice the health care resources as people who rarely drink alcohol.”

In the pilot, a risky drinker was defined as anyone who consumes more than the amount of alcohol considered safe by the government. This is one drink per day for women (or no more than 7 drinks per week) and two drinks per day for men (or no more than 14 drinks per week). In past studies, casual drinkers who drink too much may have been overlooked because the primary focus is often on identifying and engaging people who meet criteria for alcohol dependence rather than this broader focus on those who misuse alcohol.

Similar studies completed by GWU and other research institutions have shown that SBI can be very effective in the identification of risky drinkers. Identification can then lead to behavior changes. These changes can improve health and productivity of individuals and eventually reduce long-term health care utilization and cost. A 1999 study by the Substance Abuse and Mental Health Services Administration (SAMHSA) found a positive connection between the administering of SBI to risky drinkers and the decrease of risky drinking¹. Another study conducted by the Naval Safety Center found the administration of SBI contributed to a reduction in the problems associated with alcohol misuse such as DUIs². A 2005 study by research scientists R.S. Spicer and T.R. Miller showed a correlation between the use of SBI and the decrease of workplace injuries³.

"Substance abuse problems lead to many other health, social and occupational problems such as accidents, health issues, financial and legal problems,” said Dr. Eric Goplerud, director of the Ensuring Solutions to Alcohol Problems initiative at GWU. "Our research has shown that administering effective SBI to these at-risk individuals holds the promise of significantly improving the health, social and occupational status of many individuals.”

Aetna EAP plans to continue to use the SBI program, which was launched in July of 2008, with the pilot group and review the results again in July of 2009. The next phase of the project, targeted to begin in May 2009, will expand to include EAP members from three additional Aetna plan sponsors.

Aetna Behavioral Health is committed to providing solutions to support its members and plan sponsors in reducing the negative affects and cost impact of risky drinking. In addition to the EAP, Aetna encourages primary care physicians to utilize the SBI method and provides reimbursement. Aetna’s Alcohol Disease Management program provides case management and ongoing support for members in alcohol prevention programs. Aetna also supports medication-assisted Rx for alcohol and other substance abuse disorders.

Resources for Employers

Employers may use the alcohol cost calculator at http://www.alcoholcostcalculator.org/business/ to estimate the cost of alcohol problems to their business and the wide-ranging effects these problems can have on employees’ health and well-being as well as ways to reduce costs while addressing employees’ needs.

Ensuring Solutions to Alcohol Problems, GWU Medical Center http://www.ensuringsolutions.org/

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 37.2 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. www.aetna.com

¹ Substance Abuse and Mental Health Services Administration (SAMHSA). Brief interventions and brief therapies for substance abuse. treatment improvement protocol. Series 34. Rockville, MD: SAMHSA Center for Substance Abuse Treatment; 1999. Available at: http://ncadi.samhsa.gov/govpubs/BKD341/. Accessed on March 5, 2008.

² Nelson D. Air force anti-dui program shows promise. Norfolk, VA: Naval Safety Center. February 28, 2005. Available at: http://www.safetycenter.navy.mil/ashore/articles/motorvehicle/0013.htm. Accessed November 14, 2007.

³ Spicer RS and Miller TR. Impact of a workplace peer-focused substance abuse prevention and early intervention program. Alcoholism: Clinical and Experimental Research. 2005; 29(4): 609-611.

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