Exercising for Financial Health

We may love money, but it doesn’t love us. Ralph Waldo Emerson famously quipped, “Money costs too much,” warning about the unhappiness associated with pursing wealth. We all need money to pay bills and to enjoy a better quality of life. But there’s an insidious nature to how we spend money, how we talk with our significant others about it, and the impact finances have on our mental and physical health.

Debt, financial stress and spending behaviors are a major cause of relationship problems and often cited as a significant contributing factor in many divorces and breakups. Worrying about money and debt also causes increased anxiety, sleeplessness, depression and stress that taxes our hearts, contributes to high blood pressure, aggravates stomach issues like acid reflux and ulcers, and can lead to strokes and heart disease. When you consider that more than three out of four American families are in debt, the weight of all that anxiety becomes more apparent.

Most of us worry about money, and this time of year, that worrying gets worse. Or, we cast caution to the wind, spend beyond our means for the holidays, and figure we’ll bear down come January . . . much like we view our diets and holiday eating.  Granted, December may not be the best time to be considering cutting back on spending, so if we allow for reality and the joys of the season – and think about what we’re going to do differently in the coming months and years — that would be a great gift to ourselves and our families.

Planning and focus pay big dividends

There’s a difference between active coping and comfort coping – some of us eat more, spend more, devise short-term solutions, and find other creative avoidance mechanisms. Instead we should be thinking about informed, collaborative planning and strategies for dealing with our money issues. Creating goals is important – if we are working toward a home purchase, a special vacation, college or retirement savings we need a clear game plan and tools to help realize our dreams. So it’s important to think long term, but live with short-term daily strategies, as well.

Here are some tips for improving our financial health:

  • Make a budget. That sounds so basic and simple, yet many people fail to truly organize their financial lives, and to understand what they bring in and what goes out . . . and what they can truly afford. Is it possible that you actually spend $25 a week buying coffee and drinks on the road? Sure it is – and that’s okay, if you can afford the extra C-note a month. If you have a detailed budget and you stick to it, buying things during the day that make you happy is okay. If you can’t pay your phone bill, purchase oil for your furnace or buy a new interview suit, it isn’t.
  • Track your expenses. Whether you write it in a notebook, record it on your computer or download one of the many spending applications available for phones and laptops, tracking what we spend is an important tool for understanding our spending habits and for charting behaviors.
  • Avoid credit, or use it wisely. All that talk about how important it is to use credit cards to build up your credit report is bologna. If you can afford something, buy it with cash or use a debit card. If you can’t afford it, and it’s really important (like fixing the car, and for travel), use a credit card, but be diligent about paying it off as quickly as possible to avoid exorbitant finance charges or the seductive allure of instant gratification.
  • Talk to others about your financial concerns. Share your worries and issues with people close to you, especially your partner. Money worries cause countless troubles for individuals, for couples, and for families. The stigma and shame that accompanies money problems – and the weight of hiding those pressures – causes stress, anxiety and depression, as well. Candor and good communication helps alleviate some of the stress that comes with feeling like you’re bearing the financial burden on your own, or the sense of hopelessness that comes with every bill or debt collector’s call.
  • Consult a financial expert. You don’t have to have a ton of investment income to seek guidance from a financial planner or consultant. He or she can help you devise a savings strategy, determine wise, affordable investments, build your budget, and plan for the future more effectively.
  • Get help for managing your debt. If you have debt and it’s wearing you and your loved ones down, there are options and strategies for addressing your bottom line. Consolidation loans with a lower monthly finance charge can help you rid yourself of credit cards. Banks love when we only pay the minimum due, and profit greatly when we miss a payment and they can charge a hefty penalty. Avoid both by paying more than the minimum monthly payment, or by paying off the card completely as soon as possible.

There are services available to help negotiate payment plans and for consolidating debt, but many of them charge a service fee for this assistance. There also are support groups, free counseling services, and programs such as Debtors Anonymous, a confidential 12-step program available in Connecticut and across the country, where people with debt or spending issues can come together to examine solutions to their money issues, and find fellowship and support.

Money challenges us all, and there’s no reason to think that’s going to change. What can change is how we view our spending habits – if we’re not vague or frivolous about how, what and when we spend, we can take a big step toward improving our financial health, as well as our overall health and wellness.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Take the Lead on Workplace Wellness

It’s that time of year again – the apex of when distracted and cheerful meet pressured and busy. People are running around and more stressed than usual, especially as the days until the holidays count down. It’s also a challenging time in many workplaces, as year-end deadlines, workloads and customer expectations peak.

The good news is that the season will be done before we know it. But keeping employees healthy and well is a year-round venture. Thinking creatively and strategically, you can use the season to remind staff about healthy practices and to reinforce behaviors for the holidays, and for the new year.

Sharing educational materials about healthy eating is a good start. Eating a balanced diet that is low in saturated fats and salt and rich in fruits, vegetables, fiber, and whole grains — as well as healthy sources of proteins, vitamins and calcium — are critical ingredients for a healthier future. Eating smart helps us maintain a healthy weight and reduces our risk of chronic illnesses, including heart disease, stroke, type 2 diabetes, and certain cancers.

Remind employees that the best way to avoid overeating is to maintain a routine eating schedule during the holidays, pile our plates with vegetables and fruits, eat mindfully, take the time to enjoy our food, and consume a healthy breakfast every day. Additionally, employees can be encouraged to share meals at work, and explore smart nutrition and dietary practices informally, or through sessions at or after work with nutritionists and dietitians.

Variety is also important — sampling a small amount of everything that has different textures and colors on the table can help alleviate cravings. And eating in moderation is always key.  For more information, a good guide is the USDA nutrition website called “My Plate.” It can be found at www.choosemyplate.gov.

Plan exercise and good health practices

Physical activity is one of the most important steps we can take towards a healthier future. If employees are not currently exercising, encourage them to start slowly and build up – employers can think about introducing incentives and friendly competitions, and offering time and space for these team-building activities. Fitness experts are happy to come into workplaces to meet employees and to help them design team or personalized fitness routines.

Set simple goals such as at least 30 minutes three to five days a week of moderate-intensity aerobic exercise, or an hour per week of high-intensity aerobic exercise. The trick is to stay active – staff can take the stairs instead of elevators, and engage in a power walk instead of a power lunch. By setting goals and measuring achievement weekly, it makes exercising more fun and helps improve morale and teamwork. And by offering rewards to all who participate, you both condone and thank employees for their efforts to remain healthier and more productive.

Here are few other tips for improving health and wellness at the holidays, and throughout the year:

  • Stop smoking. Use the end of the year as an opportunity to remind employees of the value in reducing or eliminating smoking and the use of smokeless tobacco products at work and away from work. Point them to programs that are available online, in groups, and through local organizations. Many employers choose to bring smoking-cessation programs into the workplace, as well.
  • Drink alcoholic beverages in moderation. Alcohol adds calories, interferes with restful sleep and leaves you dehydrated. And while one glass a day of red wine might help prevent heart disease, alcohol abuse accounts for 79,000 preventable deaths every year, and is associated with an increased risk of liver disease and some forms of cancer, as well as tens of thousands of motor vehicle accidents annually.
  • Stay hydrated by drinking plenty of water throughout the day, and avoid snacks and foods high in salt, fats and sugar.
  • Get plenty of rest. Between traveling, shopping, and attending holiday events, it can be difficult to get enough sleep during the holiday season. But getting a good night’s rest will leave people refreshed and can also help to reduce stress. Most adults require seven to eight hours of sleep per night. Even if traveling or away from home during the holidays, try to maintain a regular bedtime routine. Also, avoid caffeine, alcohol, heavy meals and exercising right before bedtime.
  • Set realistic team and personal goals. This is a great time to plan healthy activities for the upcoming year. Consider creating a health and wellness planning team or committee, link activities to monthly health-awareness topics, and work with your Wellness Champion to incorporate ideas available through CBIA, insurance providers, and other health and wellness resources.

Employers play an important role in their employees’ health and wellness. By taking the lead, communicating your interest, and encouraging participation, 2017 will be a healthier year for everyone!

If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Changing more than the clocks

It’s already November – we’ve turned back the clocks and are readying ourselves for shorter days and inevitable cold weather. November also heralds the start of the holiday season. With Thanksgiving planning on our minds and December parties storming up right behind, it’s a perfect time to contemplate healthy eating, moderation and our waistlines.

Raising nutritional awareness and changing habits are two goals Tyler Losure, the wellness champion for Connecticut Society of CPAs had in mind when he took on the health and wellness assignment this past summer. Career and Academics Development Coordinator for the Society – which has more than 6,000 members and a staff of 15 — Losure had long been involved in athletics and fitness, and concerned about his own health. He saw his wellness champion role as an opportunity to share his commitment to healthy eating and fitness with his work associates, and to have fun and build teamwork at the same time.

“We have a small family atmosphere in our office, including a few new mothers, and many of us are concerned with our health and improving how and what we eat,” Losure said. “At first we tackled the proverbial ‘low-hanging fruit,’ like switching from coffee and juice drinks to water and tea, and replacing afternoon cookies with granola bars and yogurt. That escalated into talking about healthier lunch choices, and we started comparing what we were bringing in from home and discussing choices and recipes.

“I’m also a big juicing fan,” Losure added, “so as people got interested I brought in different juicing options and recipes for tastings. Now we’re talking about getting a juicer for the office to replace afternoon coffee. Improvement starts small – even when one person does something simple and shares it, we inspire others to be more conscious of how we each are fueling and treating our bodies.”

Losure and most of the Society staff have completed their CBIA Healthy Connections online health assessments. In fact, thanks to high participation, the Company was entered into CBIA’s quarterly raffle and won a $500 Amazon gift card which they’ve added to their account for health-related activities. CBIA’s health and wellness education resources, Losure added, are appreciated and shared among staff. The organization offers gym membership discounts, and a group of employees walk together outdoors at lunch three or four times a week.

Additionally, a Connecticut Society of CPAs member who is a yoga instructor ran an onsite yoga class for other members and Society staff, and people in the office are talking openly about health and wellness, nutrition and related life choices. Management support, Losure added, and inviting everyone to participate on their own terms are important factors for ensuring successful participation and change.

“As a small company we’re comfortable enough with one another to talk about the personal decisions we’re making regarding our eating habits, and even about what may be causing stress and anxiety in the office and in our lives,” Losure explained. “We’re setting personal and group goals, and realize that healthy choices at work lead to improved lifestyles outside of work, as well. As a former rugby player and now a power-lifter, I have always been the ‘go-to’ health guru for my friends and work associates, so incorporating what I have learned and enjoy doing has been fun and inspirational. Thanks to the CBIA wellness program, I am really able to promote and encourage those around me to take better control of their lives and their health.”

If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Achieve Improved Productivity Through Wellness Programs

While there is an abundance of anecdotal evidence about the value and benefits of proactive health and wellness efforts in the workplace, statistics directly linking wellness and cost savings are harder to measure. Large companies can document the number of employees who successfully complete smoking-cessation programs or achieve weight-loss goals, but it’s been more difficult for smaller employers to determine how exercise, eating healthfully and living a more conscious lifestyle translate into other known benefits such as cost savings, decreased absenteeism, improved morale and enhanced teamwork.

But current research has established a definitive link between wellness programs and improved productivity. A study currently under review and co-authored by a faculty member at Washington University in St. Louis empirically tested how wellness programs affect worker productivity. The research paired individual medical data from employees taking part in a work-based wellness program to their productivity rates over time.

The researchers used a three-year panel of medical data for 111 employees and compared them to their work performances, which were accurately measurable by the number of pieces or tasks completed in a factory setting. The researchers also used self-reported data from the employees, as well as evaluations from physicians who examined each employee’s medical progress as the program continued. All information was kept confidential and anonymous.

The researchers compared data for employees who participated in the health plan to employees at the same company who opted out of the program or were in plants that weren’t offered the full program. When they analyzed participant data, the researchers found wellness programs boosted employees’ health and productivity – in fact, productivity jumped by 5 to 11 percent compared to those that didn’t participate in the program. When further quantified, that figure equaled a whopping 528 percent return on investment for the company after introducing its wellness program.

Help your employees to help themselves

The simplest step an employer can take for improving wellness is to encourage his or her staff to use online resources that are free, easily accessible and extremely useful. CBIA Healthy Connections offers a free, confidential online healthcare assessment that takes no more than 15 minutes to complete. Employees completing their assessment receive a $50 Amazon gift card – and the more employees who complete their assessment, the more entries into a quarterly company raffle for a $500 Amazon gift card. Companies also get entered in raffle drawings for completing workshops and sharing wellness stories.

There is a wealth of other resources and tools at the CBIA Healthy Connections website as well. These include

  • An exercise planner
  • Training videos
  • Food log
  • Meal planner and recipes
  • Cardio planner

The exercise planner allows participants to choose a plan and activity level that works for them, ranging from beginning walker, to boot camp or various cardio workouts.  The meal plan tool allows users to choose the plan type they prefer based on their personal nutrition goals. It can be customized for calorie range, dietary restrictions and other options.

Videos at the website teach specific exercises based on personal interests – visitors can choose videos that focus on core exercises, upper or lower body, or stretches – including instruction on more than 15 types of exercises. And a nutritional-needs option, linked to the healthcare assessment, helps people keep track of daily vitamin and mineral intake, and offers suggestions on how to meet these specific nutritional assets. It also provides a weekly customized progress report so users can track their results.

Many similar tools are available through benefits providers and at their websites. Getting started, though, is easy – with simple-to-understand and use resources literally at your fingertips! Check out the CBIA Healthy Connections website at cbiahealthyconnections.com for more information, or call Michelle Molyneux at 860.2441966. Increased productivity and improved wellness are within reach, regardless of a company’s size or focus.

Look Into Your Phone and Say “Aaahhh”

For those of us old enough to remember The Jetsons, their flying car was only one of the many futuristic perks imagined way back in 1962 by the show’s creative producers, Hanna-Barbera. The pioneering duo also foretold holographs, robot servants, talking computers . . . and tele-medicine!

Their version of remote diagnostic care was to have a family member stick their arm in a portal in the wall, which would “read” their symptoms and offer a diagnosis. As far-fetched as that might have seen back in the day, today it’s far closer to reality. Patients with congestive heart failure, diabetes and other ailments can step on automated scales in their homes, which measure their weight and send the data electronically to monitoring services. An appreciable weight loss or gain could indicate a problem – it’s flagged by the system, and a nurse then calls the patient to check in. People also can have their blood pressure, heart rate and sugar levels checked remotely using electronic sensors, communicate online with their physician’s offices, and access a wide variety of personal medical information and history via private electronic portals.

More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30 percent this year. And according to the American Academy of Family Physicians, 41 percent of family practice physicians use electronic portals for secure messaging, another 35 percent use them for patient education, and about one-third use them for prescribing medications and scheduling appointments.

For all the rapid growth, however, significant questions and challenges remain. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver in what forum. Complicating matters, rules defining and regulating telemedicine differ widely from state to state and are constantly evolving. In Connecticut, for instance, physicians cannot be compensated for services provided over the telephone, via fax or electronically, and are not allowed to prescribe controlled substances through tele-health services.

Another huge hurdle is physician compensation. Legislation today severely limits telemedicine. And without financial incentives to provide care electronically, physicians are reluctant to get onboard, especially since health insurance, which varies from plan to plan, covers only a narrow range of electronic services.

The future of telemedicine in the United States will depend on how regulators, providers, payers and patients can address these challenges, and the issue of quality versus convenience.  For example, there are a variety of on-line services now available where a patient can connect with a clinician for one-time phone, video or email visits on demand. These, typically, are for non-urgent-care issues such as colds, rashes and headaches. They cost far less than a trip to a physician’s office, or to an urgent care center or hospital.

Many large employers and their insurance providers are offering these services to the employees as a cost-saving alternative.  However, these services lack the bonds of trust and communication that are built over time between patient and caregiver, and can’t replace the value of a personal physician or health expert listening to your heart or lungs, peering into your throat, eyes or ears, drawing a culture sample or tapping other in-person diagnostic skills.

Over the past year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring as well as store-and-forward technologies (where patients and doctors send records, images and notes at different times), in addition to real-time phone or video interactions. Medicare, the federal health plan for the elderly, covers a small number of telemedicine services — only for beneficiaries in rural areas, and only when the services are received in a hospital, doctor’s office or clinic.

There are many additional challenges. Everyone is looking at how to manage state’s rights against national priorities and demands, never an easy task. Malpractice issues are complicated, and many physicians simply do not feel comfortable rendering services online or via a phone. Still, every day brings new technologies, legislation and efforts to respond to changing patient and physician needs.

When you look at emerging smart phone technology and the portable monitoring devices we now wear on our wrists to monitor steps, sleep, heart rate and more, it’s easy to imagine how quickly future generations of health monitoring tools will evolve. And it’s probably a safe bet that we’ll be using them to help manage our health long before we’re flying to work in our own personal aero-cars!


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

It’s Not the Size That Matters

As summer wraps up and we get into the autumn months, most of us are coming off of a cycle of outdoor activity and recreation that diminishes with the shorter and colder days. The holidays will be upon us before we know it, as well as the requisite excess eating and drinking that accompany the season. But with a few months left in the year, it’s also a good time to take stock of your health and wellness activities, and to consider what’s worked well, what hasn’t worked, and what you might do differently or better next year.

There are numerous national studies documenting the value and benefits of having a formal employee wellness program. Companies that implement wide-ranging programs reap benefits in improved employee satisfaction, productivity and morale. Sick days and absenteeism diminish, and participation in the programs increases.

For large companies, the return on investment is clear. But even for smaller companies, the impact can still be dramatic, especially in terms of personal health and attitude, in teamwork, and in respect for the employer.

Regardless of the size of the company, there are certain aspects of implementing health and wellness efforts that are consistent and proven. Here, for example, are key facilitators common to all organizations that have successfully implemented a health and wellness program:

  • Broad outreach and clear messaging from organizational/company leaders.
  • Making wellness activities convenient and accessible for all employees.
  • Making wellness an organizational priority among senior leaders, middle managers and supervisors.
  • Leveraging existing resources and building relationships with health plans to expand offerings at little to no cost.
  • Approaching wellness with a continuous quality-improvement attitude; and
  • Soliciting regular feedback from employees to improve programs and participation.

There are other constants, as well. For companies that implement and promote the use of online health-assessment tools, researchers find statistically significant and clinically meaningful improvements among program participants, especially in exercise frequency, smoking behavior and weight control. Additionally, participation in a wellness program over five years is associated with lower health care costs and decreasing health care use. And outreach to employees works more effectively when a company appoints a wellness champion who can help coordinate activities, approach management, share educational information and solicit candid feedback more easily.

Approximately half of U.S. employers offer wellness promotion initiatives, and larger employers are more likely to have more complex programs. Programs often include wellness screening activities to identify health risks, and interventions to reduce risks and promote healthy lifestyles.

For smaller companies, implementing formal smoking-cessation, nutrition and exercise programs isn’t as easy – but encouraging employees to establish and pursue personal goals, recognizing their efforts and rewarding them for their commitment and success is not difficult. Often, smoking-cessation and exercise programs are available through local chapters of national organizations, or through local fitness and nutrition centers. It just takes support and commitment.

Healthy employees are more productive and happy employees, and statistically, they tend to remain with employers longer when their interest in a healthier lifestyle is encouraged and supported. The most successful small-company wellness programs may start out simply and evolve, but the trick is getting started and building momentum . . .  the rest will follow!

If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Sometimes, getting stuck isn’t bad

Can you remember the last time you had a tetanus shot?  In fact, can you remember the last time you had any kind of shot at all? If you can, chances are it was a flu shot, since most of the immunizations we require are received during childhood. But there are other immunizations we should be receiving periodically, because some lose their effectiveness over time.

Checking up on your personal immunization record, and making sure your loved ones are properly immunized as well, is a simple and critical step for helping to protect yourself and your family from preventable illness and related serious medical conditions. And if you’re an employer, encouraging your staff to do the same helps protect them, their families and everyone around them.

Even though some diseases, such as polio, rarely affect people in the U.S., all of the recommended childhood immunizations and booster vaccines are still needed. These diseases still exist in other countries. Travelers can unknowingly bring these diseases into the U.S. and infect people who have not been immunized. Without the protection from immunizations, these diseases could be imported and could quickly spread through the population, causing epidemics.

Additionally, influenza – the flu – mutates and reappears in different strains, requiring different vaccines every year. Organizations like the Centers for Disease Control (CDC) and World Health Organization work together to try and identify likely strains and prepare millions of doses of flu vaccines, which typically are administered from late summer to early winter to children and adults. They are safe, readily accessible and effective – and side effects are rare.  When employees get the flu or another preventable illness, they miss work and get other people sick.  That has a negative impact on productivity and service, and the related healthcare costs are significant.

August is National Immunization Awareness Month. Non-immunized people living in healthy conditions are not protected from disease; only immunizations prepare the immune system to fight the disease organisms. Most of us choose to immunize our children from the day they’re born. In fact, children can’t attend public school, go to camp, compete in many sports or travel outside of the country without a proven medical history of required immunizations. But as adults, we may not have received all the necessary immunizations, some of them may no longer be working effectively, and others, such as the vaccination for tetanus, have to be repeated periodically … in the case of tetanus, once every 10 years.

Today, children and adults receive a “Tdap” booster for tetanus, diphtheria, and pertussis. If you doubt the importance of this, note that pertussis (Whooping Cough) has recently reappeared in Connecticut. Pertussis is caused by bacteria spread through direct contact with respiratory droplets when an infected person coughs or sneezes. The reason for its reemergence, experts believe, is because our bodies may have stopped producing antibodies in response to the vaccinations we received as children, or because some parents are not protecting their children through recommended vaccinations. This disease is particularly dangerous for babies, so protecting yourself also protects others.

Diphtheria, also prevented through the Tdap booster, is a very contagious bacterial disease that affects the respiratory system, including the lungs. And Tetanus, which is caused by bacteria found in soil, enters the body through a wound, such as a deep cut. When people are infected, the bacteria produce a toxin in the body that causes serious, painful spasms and stiffness of all muscles in the body. This can lead to “locking” of the jaw so a person cannot open his or her mouth, swallow, or breathe. Complete recovery from tetanus can take months. Three of 10 people who get tetanus die from the disease.

If you can’t remember if or when you had your Tdap booster, talk to your doctor. Additionally, if you or your employees plan to travel outside of the United States or Canada, it’s wise to speak with a physician or an infectious disease specialist about immunizations to consider, such as protection against Hepatitis A, before traveling. In many foreign countries, especially third-world nations, diseases can still be contracted through impure water systems, through food that hasn’t been properly protected, and by air-borne particles.

If your personal immunization record doesn’t exist or has been lost, your physician can order a simple blood test that checks for the antibodies currently active in your system. He or she can then offer you the missing vaccinations, bringing you up-to-date as required. Typically, you’ll only have to do this once, unlike the vaccination for preventing influenza, which has to be received annually. Influenza may lead to hospitalization or even death, even among previously healthy children, so it’s smart to speak with your doctor annually about whether or not you should respond proactively rather than take your chances.

Protecting ourselves and our loved ones is our most important job. Today’s medical advances and access make that far easier, but only if we each take personal responsibility to ensure that our immunizations are up-to-date. Encourage staff to stay on top of their personal immunization histories, consider offering flu-shot clinics at your worksite, and share this information to promote good health and wellness for everyone. For more information, call toll free 1-800-CDC-INFO (1-800-232-4636) or visit http://www.cdc.gov/vaccines.


If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Opiate addiction: Alive and well and thriving

The statistics involving opiates and opioids in Connecticut are grim, and unless you’ve been paying attention, may be surprising: Our State has surpassed the national death rate for drug and opioid overdoses since 2013. From 2000 to 2014, nearly half a million persons in the United States died from drug overdoses, according to the Centers for Disease Control and Prevention (CDC).

The number of prescriptions for some of these medications has increased dramatically since the early 1990s. A consumer culture willing to “take a pill for what ails us” — and the perception of prescription drugs as less harmful than illicit drugs — are other contributors to the problem.  As a result, unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, and by 2007, outnumbered those involving heroin and cocaine. There has been a rash of high-profile tragedies involving these drugs, including the recent death of singer/songwriter Prince from an overdose of fentanyl. But you don’t have to be rich or famous to access and abuse drugs.

According to several national surveys, prescription medications, such as those used to treat pain, attention deficit disorders and anxiety are being abused at a rate second only to marijuana among illicit drug users. The consequences of this abuse have been steadily worsening, reflected in increased treatment admissions, emergency room visits, and overdose deaths.

Why are opioids effective – and dangerous?

Opioids are synthetic drugs manufactured to work similarly to opiates like heroin or morphine. They include drugs like oxycodone, methadone, hydrocodone, hydromorphine, and fentanyl. In the past several years, the use of opiates, including heroin, has increased significantly in Connecticut, as have fatal doses. In 2015 alone, heroin played a role in 415 deaths in our state.

Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs attach to their receptors, they reduce the perception of pain. Opioids can also produce drowsiness, mental confusion, nausea, constipation, and, depending upon the amount of drug taken, can depress respiration.

Some people experience a euphoric response to opioid medications, since these drugs also affect the brain regions involved in reward. Those who abuse opioids may seek to intensify their experience by taking the drug in ways other than those prescribed. For example, OxyContin is an oral medication used to treat moderate to severe pain through a slow, steady release of the opioid. People who abuse OxyContin may snort or inject it, increasing their risk for serious medical complications, including overdose.

Data shows that people who use opioids non-medically don’t typically get them from doctors or prescriptions. Rather, they come from a relative’s medicine cabinet or a friend, and more often than not, the addiction can stem from a legitimate use, such as a prescription for painkillers following dental work, surgery or to help manage chronic pain.

Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for non-medical reasons at least once in their lifetimes. A National Institute on Drug Abuse survey found that about one in 12 high school seniors reported past-year nonmedical use of the prescription pain reliever Vicodin, and one in 20 reported abusing OxyContin — making these medications among the most commonly abused drugs by adolescents.

Tightening controls on prescription pain killers, however, drives some people abusing pills to switch to heroin, which is cheaper and far more available. In fact, according to CDC data, heroin use is rising again even as abuse of opioids is leveling off.  From 2014 to 2015, the number of times fentanyl was found in the bloodstream of overdose victims increased 150 percent, and last year it was responsible for one quarter of all drug overdoses. Law-enforcement officials report an increased availability of illicitly manufactured fentanyl, and drug dealers cut heroin with fentanyl to increase the potency of the product.  Drug overdose deaths involving heroin continue to climb sharply, with heroin overdoses more than doubling from 2012 to 2015.

Addressing the problem

Addiction, which can include physical dependence, is distinguished by compulsive drug seeking and use despite sometimes devastating consequences. Someone who is physically dependent on a medication will experience withdrawal symptoms when use of the drug is abruptly reduced or stopped. These symptoms can be mild or severe (depending on the drug) and can usually be managed medically or avoided by progressively reducing dosage and frequency.

Dependence is often accompanied by tolerance, or the need to take higher doses of a medication to get the same effect. When tolerance occurs, it can be difficult for a physician to evaluate whether a patient is developing a drug problem, or has a real medical need for higher doses to control their symptoms.

Taken as prescribed, opioids can be used to manage pain safely and effectively. However, when abused, even a single large dose can cause severe respiratory depression and death. Properly managed, short-term medical use of opioid analgesics rarely causes addiction.

Only under a physician’s supervision can opioids be used safely with other drugs. Typically, they should not be used with other substances that depress the central nervous system, such as alcohol, antihistamines, barbiturates, benzodiazepines, or general anesthetics, because these combinations increase the risk of life-threatening respiratory depression.

Always follow the prescribed directions, be aware of potential interactions with other drugs, never stop or change a dosing regimen without first discussing it with a healthcare provider, and never use another person’s prescription. Additionally, unused or expired medications should be properly discarded per U.S. Food and Drug Administration (FDA) guidelines or at U.S. Drug Enforcement Administration collection sites.

For people experiencing dependency or addiction issues, there are medical solutions. Years of research have shown that addiction to any drug (illicit or prescribed) is a brain disease that can be treated effectively. Treatment takes into account the type of drug used and the needs of the individual. Successful treatment may need to incorporate several components, including detoxification, counseling, and sometimes the use of addiction medications. Multiple courses of treatment may be needed for patients to make a full recovery.

Rich or poor, black or white, living in the city or in the country, it doesn’t matter – the reach of illicit drug use touches all walks of life. If someone you know may be abusing pain killers, consider speaking with them and suggesting they talk with their physicians or other healthcare providers for guidance, and recognize the same issues in yourself if you’ve been using pain medications, even for legitimate purposes.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Take a vacation already, will ya?!

Experts tell us it is important to occasionally turn off and restart our cell phones, computers, and “smart” TVs. This refreshes memory and allows system updates to download and install. Similarly, when we sleep, our bodies self-regulate, refurbishing depleted nutrients, switching focus to other parts of our brains, and promoting metabolic changes that help replenish and strengthen us.

Knowing this to be true, doesn’t it make sense that taking a vacation from work is just as vital for keeping us fresh, focused and healthy? You’d think so, yet it’s amazing how many people, including senior leaders, resist taking this critical personal time and suffer as a consequence . . .  as does their work and their businesses.

We don’t take time off for many reasons. Typically these include having too much work to do, fear of losing our jobs, or being unable to afford to go away. Of a more insidious nature, with tough workloads and schedules, cost issues and market demands, employers often send mixed signals to their staff about accommodating time off. Instead of being supportive, there’s often the unspoken caveat, “Sure, take the time off, but make sure all your work gets done and nothing falls through the cracks.” The insinuation is that vacations are inconvenient, and the time is allowed reluctantly instead of graciously as the earned benefit and healthy break it represents.

Time off from our jobs and our regular routines helps us manage stress, improves our bonds with family, friends and co-workers, can alleviate fatigue, and strengthens our immune systems. When we’re stressed our work performance suffers. That has an impact on customer service, as well as on safety, quality and productivity. Most of us are harder to get along with when we’re under pressure and feeling anxious, and more prone to depression, memory loss, distraction and bad decision making. We eat poorly and sleep less. And while vacation or time away from work and our regular routines won’t cure it all, vacations offer an important break.

Ironically, the United States lags behind most developed countries when it comes to paid vacation time, and vacation is typically not mandated in our country, or a legal right. In contrast, the United Kingdom requires employers to give at least 28 vacation days. In Finland, France and Greece the minimum is 25, and in Germany and Japan, it’s 20.

As in all other aspects of work, those in senior positions should lead by example. If a business owner or executive is not taking any paid time off – or if he or she goes on “vacation” but are still accessible 24/7 – they are making a clear statement about how employees should treat their own vacation time.

Here are some additional reasons why taking vacation time off for you and your staff is so critical:

  • Time away from work empowers and motivates employees. Leaving the office for a week or two forces you to shift major responsibilities to your supervisors and other employees. This fosters more of an entrepreneurial spirit, empowers staff, and can actually boost productivity. Furthermore, it instills confidence, promotes delegation, demonstrates that they are trusted, and shows that things won’t fall apart when the boss is away.
  • Vacations – or a failure to vacation – points to other potential problems. When employees are not using their vacation days, it can indicate a problem with the team, with their workload, or with delegation and supervision.  Employees may be overwhelmed or choose to not take time off to cover up wrongdoing or gaps that need to be addressed.
  • Time away helps you and your staff develop a new or fresher perspective.For many of us, time off actually fuels creativity and gives us the opportunity to think about solutions to problems and efficiencies that can’t be addressed at our normal work pace and with everyday work pressures and distractions.
  • Disengaging is healthy.Taking a break from work and our daily routines refreshes us physically, mentally and emotionally. Sometimes we simply need to be away from our work “families” and the constant pressure of deadlines, customer expectations, commuting and even the same boring lunches, sounds and surroundings.

Even when we enjoy and value our jobs and the people we work with, getting away promotes better health and reinvigorates us on many levels. Leaders need to remind their staff how important vacation time is to the employee and to the company, and walk the talk.

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If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

The cost of under-utilizing healthcare benefits

These past several years have seen a significant shift to more cost sharing between employers and employees. Specifically, the trend has been to higher-deductible plans, increased co-pays and revamping traditional POS, PPO and HMO coverage in favor of health savings accounts and related  plans designed to help employees and their families manage their health and the cost of care. The good news is that this evolution is helping to control the annual cost of employee premiums for many members, but employees’ out-of-pocket costs now have to be managed differently to compensate for the higher-deductible alternatives.

Reaching that deductible means writing a check, paying cash or swiping a card for covered medical costs like visits to physicians and health facilities, and for tests and pharmacy requirements. Once employees and their covered family members achieve the deductible threshold, more robust insurance coverage — often including tiered pharmacy coverage — kicks in, significantly reducing out-of-pocket expenses.

One of the challenges of these modern benefit payment arrangements is that some people may resist paying for services they don’t deem necessary – like visits to the physicians when they or their dependents are sick or injured, or the purchase of drugs and medicine at retail cost – because of the cash outlay. They also may “horde” medical care, waiting until later in the benefits year when they’ve reached their deductible before seeking costly diagnostic imaging and other tests, or for filling prescriptions.

Fortunately, many benefits such as annual physicals, mammograms and Pap Smears, eye exams, scheduled immunizations, flu shots and more are covered by many plans without a co-payment.  But just because they’re covered doesn’t mean members are taking advantage of these benefits, and relying on insurance providers alone to drive home this utilization message isn’t enough.

Employers share responsibility for ensuring that employees understand their benefits plans, utilize them properly, and have someone to speak with if they have questions or concerns. And while you can’t easily check to see if employees are going to their doctors when they have a cold, or getting their flu shots in the fall, there are steps we can take to address benefit usage and to help ensure understanding and compliance.

These include holding benefits communication meetings or discussing plan coverage at staff meetings, luncheons or during work hours. Your designated human resources person should be available as a resource, and you can consider bringing health screenings for blood pressure, body mass index, cholesterol and sugar levels in-house. Nutritionists, fitness coaches, massage therapists and other health professionals also make “office calls.” Flu shot clinics can be offered at many work sites, and employers can distribute literature, send emails, post information on websites or Facebook pages and text related health-benefit information to employees.

Some companies hold internal contests or challenges to incentivize employees, and engage collaboratively with their health benefits providers, who also often a wide range of supportive communication, outreach and education options relating to general benefits, and to your specific benefits coverage. Many also offer private access to healthcare portals where members can see a confidential record of their benefits usage, get information on appointments, review test results, ask questions and more.

Health plan options and benefits are going to continue evolving as the nation works to get a handle on runaway healthcare costs, the high price of medicine, and clear information about compliance, prevention and warning signs. High-deductible plans aren’t likely to disappear anytime soon, but employers and their benefits providers can work together to help ensure proper utilization, clear communication, and a path to improved health and wellness without adding extra costs.

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If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!