Opioids in Work Comp: Gaining Visibility

Wednesday, November 9, 2011 | 0

Most workers' comp executives have moved opioid abuse and overuse to the top of their "we've got to fix this now" list.

Those who haven't, should.

Here's why.

Employers and insurers will spend $1.4 billion on narcotics this year; the vast majority of those dollars will pay for opioids OxyContin, Percoset, Actiq, Vicodin and the like.

In all likelihood, hundreds of claimants are dying every year as a direct result of opioid abuse.

There's very little credible evidence that long term opioid use is appropriate treatment for work comp injuries. These are drugs primarily developed and approved by the U.S. Food and Drug Administration for treating end-stage cancer pain. Not much cancer in work comp.

There's ample evidence that long term opioid use leads to longer claim duration, long term disability, higher costs and much more medical expense. And that's on top of the damage it does to relationships, families, and society.

The insurance industry is beginning to focus on this as a critical problem, one that, although it is societal in nature, directly and dramatically affects employers and policyholders. Regulators and legislators are also keenly interested; I participated in an International Association of Industrial Accidents Boards and Commissions webinar earlier this week along with Dr. Kathryn Mueller, medical director for Colorado's work comp system and Dr. Gary Franklin, medical director for the Washington State Fund. There were more than 170 folks on the call, a clear indication of how important the issue is.

The big insurance trade groups are also addressing opioid use, driven by members looking for so-far elusive solutions to a problem costing their policyholders billions in added, unnecessary cost.

It is also going to be the subject of at least one session in next week's workers comp conference and is on the agenda for the Workers' Compensation Research Institute conference later on this month as well.

This is long overdue but nonetheless very, very welcome.

To quote Dr. Franklin, this is a "hair on fire" issue and if your hair's not on fire yet, you're either a) bald or b) not paying attention.

<i>Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers, and owner of Health Strategy Associates, a Connecticut employer consulting firm. This column was reprinted with his permission from his Managed Care Matters blog at http://www.joepaduda.com</i>