Insight, analysis & opinion from Joe Paduda


Managing Opioids in workers comp – What to do?

I’m up at zero-dark-thirty this am to catch a flight to St Louis, where the International Association of Industrial Accident Boards and Commissions (IAIABC) is hosting a meeting addressing many of the biggest issues confronting workers comp. The three-hour session I’ll be wrapping up today focuses on managing narcotics in work comp, and I’m hoping to learn what works and how.
Unfortunately, it looks like there’ll be a lot more discussion of the size, extent, and impact of the problem of overprescribing of narcotic opioids as there aren’t a lot of long term success stories out there.
There are myriad reasons for the huge growth in the volume of narcotics prescribed in the United States, many of which are way outside the control of those of us in the work comp space. As happens so often in comp, we’re buffeted by societal, economic, cultural, and demographic factors, often left to wonder how the world changed so quickly, and so dramatically, and what, if anything, we can do about it.
Fortunately, there are a couple models out there that hold out significant promise, that appear well-designed to help moderate the growth in the use of narcotics.
Perhaps the best is from Washington State, where the state fund (known as L&I) has long been aware of the issue, and under the leadership of Gary Franklin, has been working diligently to develop and implement intelligent solutions.

I’m going to be listening hard today to the other speakers, and will report back on what I learn.
Thanks to IAIABC for dedicating the time this issue so desperately requires.

One thought on “Managing Opioids in workers comp – What to do?”

  1. As an injured worker I was assured over & over again that it was not possible to get addicted to the pain medication I was on. Then when it was clear that I was addicted I was not able to get help to get off of the medication. I had no choice but to go cold turkey which put me and my family through hell.
    Looking back what annoys me the most is that I was not offered non-opioid pain control or even pain understanding. I was given pain killers including steroid injections and pethidine injections, and repeats for as much as could be legally dispensed.
    I could have bottled my urine and sold it on the streets for others to also get a huge high.
    Doctors need to understand that injured workers need a lot more than a prescription for what ever pain pill is easiest to write out.
    Injured workers need to understand that pain relief medication is highly addictive.
    Some where in the middle of that mess is a best practice concept that will not have injured workers turning into legal drug addicts as well as doctors actually practicing medicine.
    Yours in service
    Rosemary McKenzie-Ferguson
    Work Injured Resource Connection
    South Australia

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Joe Paduda is the principal of Health Strategy Associates




A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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