Opioids in Workers’ Compensation, the Cost, Chronic Pain & Responsibly

Opioids utilized in the treatment of workers’ compensation claims come at a high cost to all parties involved. You may read a number of white papers creating awareness on opioids, yet they continue being a plaguing problem for the industry. The answer today is not waiting for official government policy to come in and set the tone. The physician has the legal responsibly though the carrier, employer or third party administrator needs to step up and take accountability for if nothing more following a moral compass as each claim is unique to own merits. When no accountability is taken, we all are not part of the solution but part of the problem.

To my belief, the use and over prescribing Opioids in treatments at times are a result of limitations placed on the carrier’s physician’s for diagnostic studies to be performed early on. Short term use for a sudden onset due to a claimant’s specific injury and to manage pain of course, may be required initially, though the physician should bear the responsibility and (at least for the carrier on the moral issue) to promptly order recommended diagnostic studies to solve the problems at hand instead of just masking them, with letting the physicians continue to run with these types of medications.  The cost incurred for a diagnostic study vs. the potential (TCOR) Total Cost of Risk to be incurred in association with the inappropriate use of Opioids in ongoing treatment far outweighs the long term costs benefits of the claim and what is right for the injured worker. Opioids, besides the potential addiction to the claimant, carry at a minimum know from various studies already performed, 19% higher cost for the life of the claim to start.  There is a great financial benefit for the carrier, employer and third party administrator in stepping up to do what is right. One person can make a difference within the system and when dealing with people’s lives, the choice is quite simple.

Personally as a past claimant for almost seven years within the system, with a chronic neurological pain condition and protocol for the use of opioids was unacceptable to myself. This was at a time in 2004 through 2011 when no one was even looking at the opioid addiction crisis truly. Luckily for myself, I was able to avoid them totally, utilizing anti-inflammatory based drugs as needed, though not without trial and error. No one feels another’s pain, the most cost effective solution is to treat the injury when possible, not masking it, at the very least will help curb the opioid addition and may return the claimant to work when possible. This becomes a true victory as the carrier drastically reduces the administrative costs and the claimant may not get hooked on opioids. Why keep pushing the same model in a broken system, as the old saying goes, don’t put off till tomorrow, what you could do today!

Written By:

Paul Gold

Founder & CEO

PG Resolutions Group