The Family Behind the Diagnosis: Why Supporting SUD Caregivers Is a Health Plan and Employer Imperative

The person in recovery has a care team. The family member supporting them, more often than not, has no one.

According to SAMHSA’s 2024 National Survey on Drug Use and Health, 48.4 million Americans, 16.8% of the U.S. population aged 12 and older, met the criteria for a substance use disorder in the past year.¹ For each of those individuals, there are family members navigating the confusion of treatment decisions, the weight of crisis management, and an emotional burden that the healthcare system rarely acknowledges and almost never addresses directly.

These caregivers are unpaid, largely unsupported, and invisible to the plans and employers paying for their care. That invisibility has a cost.

Trualta has launched the Substance Use Disorder (SUD) Caregiver Toolkit to close that gap and to give health plans, employers, and benefit administrators a concrete way to reach these families before crisis escalates.

Read the full press release here: Trualta Launches Substance Use Disorder Toolkit to Support Caregivers on the Frontlines of Addiction

The Cost of Leaving SUD Caregivers Without Support

When a member living with substance use disorder drives up healthcare utilization, health plans and employers see it in the claims data. What’s harder to see, but equally real, is the utilization generated by the people caring for them.

The direct cost of SUD to employers is substantial. A peer-reviewed analysis of employer-sponsored insurance data found the annual attributable medical expenditure for employees with an SUD diagnosis was $15,640 per affected enrollee, totaling $35.3 billion across the insured population.² A 2025 study published in the American Journal of Preventive Medicine put SUD-related productivity losses from absenteeism, presenteeism, inability to work, and lost household productivity, at $92.65 billion in 2023 alone.³

Those numbers only count the person with the diagnosis. They don’t count the plan member whose own mental health is deteriorating while supporting someone through treatment and recovery. Research shows that the burden family caregivers carry in substance use disorder is comparable in severity to caregiving for other serious mental health disorders, with depression, anxiety, and strained family functioning among the documented outcomes.⁴ For health plans and employers, that means two members at risk, and one of them has no clinical pathway designed for their emotional support. 

What the Toolkit Delivers

The SUD Caregiver Toolkit was designed around what these families actually need: structured, stigma-aware guidance that meets them where they are, across every stage of a loved one’s recovery journey.

The toolkit delivers 16 learning activities across five core sections: Substance Use Disorder Basics, Treatment & Management, Caregiver Emotions & Wellbeing, Care Recipient Emotions & Needs, and Caring for Children & Teens with SUD. Content is delivered through plain-language articles, videos, interactive scenarios, and practical tools for boundary-setting, emotional check-ins, and crisis planning. Each section was developed with clinical review from subject matter experts in SUD treatment, including Ashlie Dryden, LMSW, LMAC.

The approach is grounded in harm reduction principles, evidence-based addiction science, and person-centered care. The goal is not to overwhelm caregivers with clinical detail, but to give them the knowledge and confidence to provide safer, more effective addiction treatment support — without sacrificing their own wellbeing in the process.

“In my work with caregivers who are supporting a loved one through a substance use disorder, what strikes me most is how alone they feel in it.” said Monique Frahm, R.N. and Caregiver Success Manager at Trualta. “There’s so much shame wrapped around this experience, not just for the person struggling, but for their family. There are so few spaces that actually talk about this. This toolkit is about changing that, giving caregivers the guidance and support they need so they feel less alone in what is often an invisible struggle.”

A Gap Across Every Population You Serve

Substance use disorder touches nearly every population health plans and employers cover — across age groups, income levels, and geographies. Among working-age adults, SUD prevalence as a chronic condition is particularly significant. And within certain communities, the burden is higher still: according to VA Health Systems Research, 14% of U.S. veterans reported having at least one substance use disorder in the previous year, with alcohol use disorders the most common form, and 96% of those veterans did not believe they needed treatment.⁵

That last figure reflects a broader pattern: the people most affected by SUD, and the families alongside them, are often the least likely to seek formal support or therapy. A caregiver education resource that is accessible, stigma-free, and available through a trusted benefit channel is one of the most practical ways to change that.

Whole-Person Caregiver Support, Expanded

This toolkit represents a meaningful expansion of Trualta’s whole-person caregiver support model. Substance use disorder now joins dementia, cancer care, mental health, and workforce caregiving within Trualta’s full caregiver support library, giving health plan and employer partners a single platform to address the full range of caregiving situations with built-in peer support.

“Substance use disorder can leave families feeling powerless,” said Dryden. “By giving caregivers clear, compassionate tools to navigate boundaries, treatment decisions, and crisis moments, this resource helps them reclaim confidence and stability in an incredibly challenging time.”

For payers, employers, healthcare providers, and organizations serving complex member populations, the advocacy effort is clear: when we support family caregivers, they generate better outcomes for the people in their care, reduce avoidable utilization, and carry a lower psychological distress risk themselves. The SUD Caregiver Toolkit makes that investment possible.

Learn More

Health plans, employers, and other organizations interested in bringing the SUD Caregiver Toolkit, and Trualta’s full caregiver support library, to their populations can request more information and download toolkit details here:

https://activate.trualta.com/substance-use-disorder-toolkit

Sources

1. Substance Abuse and Mental Health Services Administration. (2025). Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 National Survey on Drug Use and Health (HHS Publication No. PEP25-07-007, NSDUH Series H-60). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2024
2. Li, M., Peterson, C., Xu, L., Mikosz, C.A., & Luo, F. (January 2023). Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population. JAMA Network Open. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972180/
3. American Journal of Preventive Medicine. (December 2025). Productivity Losses From Substance Use Disorder in the U.S. in 2023. https://www.ajpmonline.org/article/S0749-3797(25)00570-7/fulltext
4. Zandifar, A. et al. (June 2023). Comparison of Caregivers’ Burden among Family Members of Patients with Severe Mental Disorders and Patients with Substance Use Disorder. Iranian Journal of Psychiatry. https://pmc.ncbi.nlm.nih.gov/articles/PMC10293690/
5. VA Health Systems Research. (2025). Substance Use Disorders: Research Topics. U.S. Department of Veterans Affairs. https://www.hsrd.research.va.gov/research_topics/sud.cfm