Stigma and cost of treatment dissuade many people with
"I've struggled with alcohol for my entire life, and I found that during COVID especially, I was drinking way too much," says the Corning employee, who has asked to remain anonymous for the sake of privacy. "Both of my kids were gone, and the isolation was really what it was all about. I turned to the program because of my company — I don't know if I would have done it on my own, but I got emails and other notifications through my company about what the program was offering and that made me want to jump in and give it a try."
According to the National Survey of Drug Use and Health, out of the 46 million Americans who struggle with a substance use disorder, only 6% ever receive treatment. However, access to employer-provided
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"You can schedule sessions during times that work for you," she says. "You don't have to go anywhere, you don't have to leave your house," she says. "There's a lot of shame around alcoholism, or around substance usage in general — this is a way for you to get help without those feelings."
Pelago's users work alongside a team of providers to determine their care plans, which depend on the substance, severity of addiction and an individual's overall health goals. For the Corning employee, her addiction management journey also became a fitness one. With the support of her counselor, she not only achieved sobriety, but started attending workout classes as a physical and mental outlet. She lost 50 pounds. Her success isn't unique: Pelago members see a 62% reduction in alcohol use in the first 30 days of care, according to the platform.
Pelago's treatment is based on contingency management, which provides rewards or incentives for small milestones to reinforce positive behaviors. The reward can be as simple as a gift card to something of personal value to the patient.
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"What happens biochemically is that the substance people are misusing hijacks the brain's chemistry and hijacks that dopamine reward pathway, causing individuals to make decisions that are harmful to themselves," says Dr. Yusuf Sherwani, founder of Pelago. "Contingency management rebalances that reward pathway and gives people incentives to engage in behaviors that we know are correlated to success."
While Dr. Sherwani acknowledges that employers and employees alike may be skeptical about how effective virtual care is for addiction, he stresses that this kind of treatment calls for consistent patient engagement, which is less of a challenge when users have digital access to their care.
"Instead of confining people to an hour a week of group support, we break up that engagement across an entire week and try to reach people in the moment when they most need us," he says. "You still have the synchronous support from a care team member, but we're trying to reinforce specific behaviors by checking in on a daily basis, making sure that you create new habits to help overcome cravings in relation to the triggers you might have."
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For Dr. Sherwani, healthcare benefits aren't complete without a resource for addiction management, and it may be a key puzzle piece to mitigating healthcare costs. According to the CDC, substance use disorders cost employers $15,640 per affected employee each year — and that's just accounting for healthcare spend. The costs associated with productivity loss equate to an estimated $270 billion nationwide, according to the Recovery Centers for America. An analysis by Pelago found that participants' annual medical claims were reduced by more than $9,300.
"This is a group of people in the employee population that tend to correspond with some of the highest overall healthcare costs, both in substance use treatment costs, but also in just other health complications," he says. "So there's a real ROI in ensuring that people with substance use disorders do get access to evidence-based treatment."
While the corporate world has come far on the issue of substance use disorder, Dr. Sherwani knows employers still have a long way to go. He asks that they try to no longer view addiction as a moral failing — something that demands punishment rather than help. For the Corning employee, her benefits have meant the difference between being a healthy, present mom, employee and person, and falling further into a pattern of destructive behavior.
"Feeling supported and cared for in your place of work shouldn't be a question or a rarity. Benefits like Pelago should be an option for everybody," says the employee. "My kids and I are very grateful that I was able to find it and stick to it. From my blood pressure to my cholesterol, and most importantly, my relationships, everything in my life is just better now."
