How to Avoid Opioids for Workers' Comp

By Michael Galvan | 03/10/2017

According to the Occupational Safety and Health Administration (OSHA), there were nearly 3 million nonfatal workplace injuries and illness reported by private employers in 2015 alone.1 Some of the most prevalent work-related injuries are musculoskeletal, repetitive motion conditions, burns, and slip and fall cases. These injuries are often very severe and require time away from work.

Recently, both the government and private organizations have become concerned with the way that patients are being treated for illness and injury. Opioid prescriptions (powerful pain relievers that include oxycodone, hydrocodone, and morphine) have drastically increased over the years, and approximately 32% of work-related injuries are being treated with these drugs.2

With more than 33,000 opioid-related deaths in 2015,3 the highest number on record, many concerned citizens and organizations are advocating for a change in the way we view and prescribe these powerful drugs.

How many opioids are being prescribed, and for what?

In 2013, providers wrote nearly a quarter of a billion opioid prescriptions,4 mostly for chronic pain.

Chronic pain is generally defined as pain that lasts more than three months or past the time of normal tissue healing. This can be the result of several causes, but in workers' compensation cases it is generally related to traumatic or chronic injury. Chronic pain can be especially debilitating because it inhibits normal life and work functions.

How does this become a long-term problem?

While there are benefits to opioid prescriptions, they can often act as a double-edged sword. Over a long enough period, it becomes very easy for patients to develop a physical dependence on these substances. As their tolerance grows, they may find that they need more and more of the same medication to achieve pain relief. This is dangerous cycle that results in addiction and overdosing.

How do we stop this epidemic?

The government has taken several steps to try and curb the growing problem of prescription opioid abuse. As of March 2016, the FDA issued a statement that strong prescription opioid painkillers will now be required to carry a “black box” warning about the high risk of abuse, addiction, overdose and death.5 This is in an effort to hopefully slow the rate at which these drugs are prescribed and to educate patients on the potential risk.

In addition, the CDC has also just released new guidelines that educate and caution doctors on prescribing opioids for chronic pain.6 The goal of these guidelines is to encourage physicians to try other forms of treatment and cut over prescription.

As a response to the guidelines, the American Physical Therapy Association launched a #ChoosePT campaign to encourage therapy as a safer and more effective alternative to opioids.7

As an employer, one of the best things you can do to combat this epidemic is to find an occupational health provider that uses early intervention therapy, which is seen as one of the best alternatives to bed rest and opioid prescriptions. This approach uses immediate physical therapy to increase mobility and reduce healing times. By focusing on functional recovery, patients are less likely to develop chronic pain that requires prescription opioid pain medication.



References:
[1] https://www.bls.gov/news.release/pdf/osh.pdf
[2] Dembe, A., Wickizer, T., Sieck, C., Partridge, J., and Balchick, R., Opioid use and dosing in the workers' compensation setting. A comparative review and new data from Ohio. Am J Ind Med, 2012. 55(4): p. 313-24.
[3] https://www.cdc.gov/drugoverdose/
[4] IMS Health, National Prescription Audit (NPATM). Cited in internal document: Preliminary Update on Opioid Pain Reliever (OPR) Prescription Rates Nationally and by State: 2010-2013.
[5] http://www.cnn.com/2016/03/22/health/fda-opioid-black-box-warning/
[6] https://www.cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf
[7] http://www.moveforwardpt.com/choose-physical-therapy-over-opioids-for-pain-management-choosept