We are in the midst of a sweeping opioid epidemic. The prevalence of opioid pain killers for treating chronic pain in American adults has created a crisis throughout the country as these highly addictive pharmaceuticals create addicts, at times leading them to cheaper, but often devastating illegal drugs like heroin.
The workers’ compensation industry has been evaluating the impact of this epidemic as it hits employers in certain industries particularly hard. Despite decades of prescriptions being doled out, we now know that opioids are generally ineffective at treating long term chronic pain and have a very high addiction rate.
The cost has been substantial. Thousands of lives lost due to overdose, tens of thousands more deeply impacted by addiction, and $55 billion in costs in 2011to the workplace, health care, and criminal justice systems.
THE IMPACT OF OPIOIDS ON WORKERS’ COMPENSATION
Opioid prescriptions make up a large percentage of prescription drug costs in the workers’ compensation system. With 40% of costs going towards these costly and at times ineffective drugs, experts both in the insurance and health care industries have started urging doctors to perform risk assessment and drug screening at a minimum before prescribing opioid pain killers. Additionally, recommendations from the Claims and Litigation Management Alliance include managing pill count and using a drug holiday to reduce or stop treatment after one year.
State governments are taking action as well. Many are now part of drug monitoring programs, but physicians are still the lynchpin of the program. If a doctor doesn’t visit these sites to evaluate whether a patient has a history of these prescriptions or has recently filled one, there is no way to measure to stop the problem. As the efforts at the federal level stall, it remains a private and local government effort to address these issues as they continue to get worse.
ADDRESSING PAIN TREATMENT
Pain is not an illusion. The men and women who are injured on the job and suffer long term chronic ailments are in real pain and they want to get back to work as soon as possible. But the risks of opioid addiction and abuse are so great that alternatives are needed more than ever.
Therapy and long term rehabilitation are vital to this and can be promoted and discussed with staff as part of a return to work policy, while states are looking increasingly into the legalization of medical marijuana for pain management. The studies that support marijuana legalization are still sparse and the federal government continues to classify it as a Schedule I drug (which makes clinical trials impossible in the United States), but there is a movement there that will continue to gather momentum.
For now, the best we can do is be wary, communication frequently with staff, provide a supportive environment and a solid return to work policy that makes it possible for employees to be engaged even while dealing with the aftermath of an injury.
