Take our Addiction Test

Find a therapist to overcome addiction

Drug and alcohol impairment, psychiatric symptoms, and medical harm predict a greater risk of early death.

Life insurers treat substance use as an important and powerful predictor of illness and premature death.

Treatment, recovery, and sustained remission can restore health and add years to life.

We count steps, track sleep, test biomarkers, take supplements, debate peptides, and search for medications that might slow aging. Yet alcohol, tobacco, and other addictive drugs—some of the clearest threats to a long and healthy life—are missing from this conversation.

Life insurance companies do not make that mistake. Their business depends on predicting who is likely to die younger than expected.

They study thousands of lives, insurance claims, medical records, prescriptions, driving histories, and causes of death. Insurers use these sources, depending on the policy and underwriting pathway. They want to know what a person drinks, smokes, swallows, snorts, or injects to determine insurability and estimate longevity.

A banker in recovery once asked me why a life insurer wanted to know about his former cocaine use, drinking, and addiction treatment. My answer was simple: They want that information to decide whether to insure you—and at what price.

Sources of Health Information

Life insurers collect premiums while a person is alive and pay when that person dies. Naturally, they want to know about behaviors associated with dying early. An insurer may review blood or urine test results, prescription histories, medical records, driving records, and previous insurance applications. Each adds another piece to the risk calculation.

But a drug test cannot diagnose addiction, impairment, or future behavior. It establishes exposure—not a substance use disorder (SUD).

For decades, smokers have paid much higher life insurance premiums because their increased mortality risk is indisputable. After the 1964 Surgeon General’s report established the deadly consequences of smoking, life insurers began separating smokers from nonsmokers. They later incorporated urine cotinine testing to identify recent tobacco use. I remember learning about cotinine testing from a colleague who called me irate and wanted to know if the test was reliable and whether a cigar the night before could have been the culprit after he applied for nonsmoker rates and failed.

Prescription records also require interpretation. Buprenorphine or naltrexone may indicate that someone is receiving treatment. An algorithm may confuse treatment with risk. Clinicians should not.

Twenty Years of Life Lost

A landmark systematic review and meta-analysis involving 12 million people across 24 countries and regions showed that patients........

© Psychology Today