Longer-term use of opioids is costly to injured workers, their families and their employers. It may put injured workers at risk of misuse of opioids, which can lead to addiction, overdose and illegal distribution to others—a serious public health concern. Longer-term use can also substantially delay return to work and increase the total cost of a workers’ compensation claim.
New research by the Workers Compensation Research Institute (WCRI) found that nearly 80 percent of injured workers received at least one opioid prescription. In some states, as many as one in six end up using opioid medications for six to 12 months or more after their injuries.
Compounding the problem is that the use of drug testing for these patients falls far short of what medical treatment guidelines recommend. Drug testing is used to determine compliance with the medication regime, and to identify patients that may be abusing these medications.
Significantly reducing the use of unnecessary narcotics in the treatment of injured workers is the task of all stakeholders in the workers’ compensation system: employers, labor, physicians, hospitals, insurers and public policymakers. But reforming a statutory system like workers compensation takes time. Fortunately, employers can take some beneficial actions immediately.
A look at the latest research provides the insight needed for all to do the right thing. The WCRI study, Longer-Term Use of Opioids, identified a number of states where workers were most likely to be taking opioids long after their injury.
In Louisiana and New York, the study found that one in six injured employees who started taking opioids were still taking them three to six months later. In several other states, including Pennsylvania, South Carolina, California and North Carolina, the study found that approximately 10 percent of injured workers received opioids on a longer-term basis. By contrast, Arizona and Wisconsin showed the lowest percentage of longer-term users at 3 percent and 4 percent respectively.
The study defined longer-term use as patients receiving opioids within three months of their injury and continuing to receive opioids three to six months later, while having three or more prescriptions for opioids.
Among injured workers with longer-term use of opioids, approximately one in four received drug testing, including urine drug testing. Infrequent use of drug testing is inconsistent with evidence-based treatment guidelines, which recommend random drug testing to help prevent opioid misuse by patients on opioid therapy.
Treatment guidelines also recommend periodic psychological evaluations and treatment to help manage the addictive effects of these powerful drugs. In most states studied, few injured workers received these services (only 4 percent to 7 percent of the injured workers with longer-term use of opioids).