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Opioids in work comp – gaining visibility

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 FDA 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 IAIABC 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 WCRI later on this month as well.
This is long overdue but nonetheless very, very welcome.
To quote Gary Franklin MD, 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.

3 thoughts on “Opioids in work comp – gaining visibility”

  1. I remember when talking about pharmacy earned a blank stare and the Alfred E. Newman monicker “what me worry?”. We defiantly have a problem know that we can measure and manage. Question is what’s working?

  2. Hi Joe.
    Just a clarification. the FDA block-box warnings and indications that confine certain opioids to use for breakthrough cancer pain are pretty much confined to certain oral fentanyl products,( Actiq, Fentora ,etc.)
    Most other opioids are simply designated by the FDA indication of “moderate to severe pain”.
    Nevertheless, the opioid issue is as significant and critical as you point out.

  3. Joe:
    The Insurance Council of Texas is very appreciative of the fact that you are helping to keep the discussion about Rx drug abuse alive and moving forward.
    The Texas workers’ system is just one of many jurisdictions that are facing the immense challenge of addressing Rx drug abuse.
    Please keep shining your bright spot light on this issue and keep up your good work.

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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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