Chronic Pain, Musculoskeletal Conditions, and Substance Use

Chronic pain and substance use disorders (SUDs) are often tightly linked, with major impacts that reach far beyond standard health claims. As employers, the stakes aren’t just financial—they touch the heart of your organization: your people, your productivity, and your culture.

The Hidden Connection: How Pain Fuels Addiction Risks

Here’s the human reality: The journey from chronic pain to substance use is heartbreakingly common, especially when musculoskeletal (MSK) conditions—like back, joint, or neck pain—are treated with prescription opioids or other habit-forming medications. As Jamie Vin shared:

“The moment someone takes an opioid, the brain’s reward system is switched on. What starts as short-term pain relief can quickly morph into physiological dependence—the withdrawal is real: shaking, sweats, digestive problems, intense irritability, and anxiety. Too often, MSK pain is the gateway that exposes someone to these risks in the first place.”

For employers, MSK pain isn’t just a clinical category—it’s a red flag for future SUD risk, healthcare claims, and extended time away from work.

The True Cost: What’s Seen, What’s Missed, What Grows Over Time

The numbers speak volumes. Matthew Hall offered a frank perspective from Koch's own data:

“We identified $9 million in substance use disorder-related medical and pharmacy costs in a single year. The majority was alcohol-related ($5.5 million), with another $1.5 million tied to opioid dependence. And that’s just what appeared on the balance sheet. When we looked under mental and behavioral health, disability claims alone hit $5.6 million in 2024. We’re also seeing more employees struggle with pre-employment and reasonable suspicion testing, a trend that’s grown every year.”

But the numbers don’t capture the full story: When SUDs go untreated or under-treated, the risk of relapse, repeat hospitalizations, time off, and turnover multiplies. That means compounding costs, lost productivity, and strain on teams—year after year.

The Barriers Employees (and Their Families) Face

Even when employees are motivated to get help, many hit invisible walls they can’t climb over alone. Brent Nicholson puts it plainly:

“We see financial barriers, access problems, and—just as tough—stigma. Team members hesitate to ask for help because they fear judgment. They struggle to get clear answers about what’s covered, how much they’ll actually pay, or even where to start. These obstacles delay recovery and, for many, lead to crisis moments that could have been avoided.”

Real people, not just statistics, are falling through the cracks.

What Works: Bundled, No-Cost, Right-Fit Care That Treats the Whole Person

There’s a better way, gaining momentum among forward-looking employers:

• Remove cost barriers, period. Nicholson shares: “We partner with employers to cover employees’ out-of-pocket expenses for SUD treatment, so they can focus on getting well instead of worrying about surprise bills. That change alone increases treatment uptake and successful recoveries.”

• Make pricing simple and predictable. Bundled programs with relapse recovery guarantees (sometimes called “relapse warranties”) share real accountability: if a member relapses, continuing care is already covered.

• Personalize care from the start. “Data shows about 40% of patients should consider facility-based treatment, yet roughly 80% nationwide don’t get the level of care that fits their needs,” Vin notes. Closing that gap up front prevents returns to care, lost days, and burnout—for employees and their managers alike.

Lasting Change Means Treating More Than Just Symptoms

Long-term success demands more than temporary fixes or short-term detox. As Vin explains:

“Lasting recovery comes from surrounding people with support—mind, body, and spirit. We teach practical coping skills, focus deeply on nervous system regulation (things like stress response training), and include virtual wraparound services for family members, so every home environment supports progress—not just the individual.”

When the family system stabilizes, members are less likely to relapse and more likely to bring their best selves back to their team.

How to Build a Truly Seamless Benefits Ecosystem

When benefits are siloed, even the best programs fall short. Hall describes Koch’s model:

“We give every member a single digital entry point—a ‘front door’—where they can quickly find every mental health, MSK, and SUD resource available. Behind the scenes, we hold vendor summits every quarter to map the patient journey, prevent people from getting lost, and resolve referrals fast. Our members just see solutions, not red tape.”

Navigation should feel effortless for the employee, even if it takes heavy coordination behind the curtain.

A Moment Worth Remembering

Orchestration matters as much as selection, and the difference shows up on the faces and in the futures of your workforce.

What HR and Benefits Leaders Can Do Right Now

1. Cut cost barriers and complexity. Adopt zero-dollar, bundled SUD treatment programs with relapse guarantees—so employees never have to choose between help and hardship.

2. Offer a clear digital “front door.” Connect MSK pain and SUD care so employees and families know exactly where to start and what to expect.

3. Unite your vendors. Hold regular summits to map journeys, speed up referrals, and break down data silos, ensuring no one falls through the cracks.

4. Fight stigma with targeted communication. Equip managers and teams with the tools to support help-seeking and mental health without fear or shame.

5. Extend real support to families. Offer virtual coaching, educational resources, and ongoing outreach to caregivers—because recovery happens at home, too.

Ready to Make a Difference? Join Us—and See What Works

You’re not alone in facing these challenges. Join us at Movement 2026 to hear directly from peers, experts, and innovators who are transforming pain, MSK, and substance use care. You’ll leave with practical tools, inspiring stories, and actionable steps proven to work for organizations like yours.