Opioid Use and Abuse in Workers’ Compensation Claims

The National Council on Compensation Insurance reported narcotics prescriptions make up over $1.4 billion of workers' compensation medication spending each year. Opioid abuse among people who have sustained injuries at work and made workers' compensation claims has become a growing problem, according to the American College of Occupational and Environmental Medicine (ACOEM) and the International Association of Industrial Accident Boards and Commissions (IAIABC). These two organizations have collaborated to crack down on opioid abuse from workers' compensation claims. Colorado has had guidelines for doctors prescribing opioids for workers' compensation claimants for many years and those guidelines have had an impact on injured employees.

Efforts at Eradicating Opioid Abuse

ACOEM and IAIABC are arguing for a "holistic" approach to combat opioid abuse. They wrote a letter in October 2011 urging state regulators to work with healthcare providers and insurance companies to develop plans to control opioid use among workers' compensation claimants. IAIABC is offering a webinar for its members to educate them in developing plans to fight opioid abuse and has developed a resource page on its website offering more information on the subject.

Colorado's Chronic Pain Prescription Guidelines

Colorado's Division of Workers' Compensation has set strict guidelines for patients receiving opioids for extended periods. The guidelines make clear that long-term opioid use is a measure of last resort after other treatments have failed.

Patients have to undergo psychosocial and physical evaluations by two different physicians. If the evaluations show that the patient is at high-risk for developing an addiction, the physician should not prescribe opioids long-term. Patients also need to give written informed consent to take the medication and must agree to an opioid contract. The guidelines mandate that physicians conduct urine tests for patients on opioids before the patients begin using the drugs and then randomly thereafter, at least once a year.

Effects on Workers

Guidelines for prescribing opioids for workers' compensation claimants are intended to protect injured Colorado employees from additional injury. Workers who struggle with chronic pain who would be candidates for long-term opioid prescriptions face less of a risk of becoming addicted to the pills because the guidelines require their health care providers to monitor them closely. As a result, injured workers are less likely to have to battle addiction in addition to their pain from their work injuries.

The increase in opioid prescriptions for workers' compensation claimants has raised alarm about increase opioid abuse. Those in the industry are making efforts to eliminate such abuse, such as through implementing guidelines for how physicians may prescribe the medications. These steps end up protecting injured employees from suffering further injury and pain.