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Narcotic Pain Relievers Add Cost, Concern in Treatment of Work Injuries

According to the Centers for Disease Control and Prevention ("CDC"), drug overdose was the leading cause of death in 2011.  Among adults between the ages of 25 to 64, drug overdose caused more deaths than motor vehicle accidents.  Of the 41,340 drug overdose deaths in 2011, 55 percent were related to pharmaceuticals.  Of those 22,810 deaths relating to pharmaceutical overdoses, 74 percent involved opioid pain relievers.

Forty-six people die each day in the United States from an overdose of prescription painkillers, which include drugs such as Vicodin, Oxycontin, Opana, and methadone, according to a July 2014 CDC study.  In the same study, the CDC noted that  health-care providers issued 259 million prescriptions for painkillers in 2012, enough to provide every American adult with a bottle of pills.  The CDC previously reported that those at highest risk of overdose are as likely to get prescription opioids from a doctor's prescription as from a friend or relative. 

Impact on Workers' Comp Claims
Studies estimate the cost of opioid abuse to be more than $50 billion annually.  Workers' compensation claims are not immune from the high costs associated with narcotics.  Studies have shown that narcotics take up nearly 34 percent of the total drug costs in workers' compensation claims,  In the private group health arena, narcotics comprise only approximately 3 percent of total drug expenditures. 

One suspected driver of increased drug costs for workers' compensation claims is an increase in physician-dispensed drugs.  Typically, a doctor prescribes a drug and the patient obtains the drug from a pharmacy.  Physician dispensing occurs when doctors fill the prescription in their own office.  According to a study performed by the National Council on Compensation Insurance, physician dispensed drug costs per claim have doubled from 2007-2011. 

Additionally, some studies question the benefit of increased use of narcotics for common ailments like general back pain.  One study found an association between the greater use of opioids and delayed recovery from workplace injuries.  High doses of narcotics can lead to other hazards associated with drowsiness, lethargy, and the potential for overdose. 

In 2013, the Insurance Journal reported that Pennsylvania and Texas had the third highest percentage of non-surgical workers' compensation claims involving long-term narcotics users. 

Fortunately, changes are taking place.  Public awareness is increasing and Harris burg is addressing the problem.  On July 10, 2014, Pennsylvania Governor Tom Corbett announced the release of guidelines addressing the use prescription opioids to treat chronic non-cancer pain.  The governor directed the Departments of Drug and Alcohol Programs and Health to establish the Safe and Effective Prescribing Practices and Pain Management Task Force in an effort to reduce prescription abuse and overdoses.  The guidelines were developed in partnership with the Pennsylvania Medical Society, and it is hoped they will significantly reduce the number of Pennsylvanians who become addicted to prescription opioids in the future.

What Can Employers Do?
Employers, like their employees, want only the best available care for the treatment of work injuries.  Employers should work closely with workers' compensation claims representatives to achieve this goal.  Too often employers rely exclusively on claims representatives to monitor and direct health care.  Once the employee has unsuccessfully utilized narcotics on a long-term basis, the likelihood of returning to work is significantly reduced. 

Under the Pennsylvania Workers' Compensation Act, employers can designate health-care providers to treat injured workers for 90 days following the injury.  Employers should work with claims representatives to identify the most appropriate health-care providers, giving special attention to pain management.  Once the providers are identified, the employer and claims representative should monitor the quality of care, particularly with respect to the use of narcotics and compliance with medical guidelines. 

It's also beneficial to keep an open line of communication between the injured employee and the employer to assure that the employee is receiving appropriate care and service from both the health-care provider and the claims representative.  Obviously, the goal is to provide injured workers the best medical care available and reduce the risks associated with narcotics.