A recently released study on prescription drug use in treating workers' compensation patients was sponsored by the Workers Compensation Research Institute and co-authored by the medical director of Colorado's Division of Workers' Compensation.
The study reviewed data from almost 300,000 workers' compensation claims. The total number of prescriptions for pain medications associated with these cases came to more than 1.1 million, including both narcotic and non-narcotic drugs.
The study shows that the costs of workers' compensation programs may be increasing because doctors are not following guidelines for opioid drug prescriptions, leading to prescription drug dependency in some cases. It could also deter insurance companies and providers from approving claims when opiod and narcotics are an appropriate means to manage and treat pain for on-the-job injuries.
Use of addictive pain relief
While prescription narcotics can be an effective method of managing pain from work-related injuries, the drugs can, however, become addictive if they are overused, creating a new, difficult medical issue. The WCRI study showed that states varied widely in identifying injured workers as longer-term users of narcotics in workers' compensation claims filed between 2009 and 2011.
The highest rate of long-term opioid users was in Louisiana, where one in six claimants fit into that category. New York followed closely behind, with one in seven. The lowest rate of long-term narcotics users was less than one in 20, in states including Wisconsin, Arizona and Iowa.
The study does not indicate that workers themselves are abusing the workers compensation system, only that doctors may not be following proper protocols in how they treat and manage chronic pain with these types of injuries. The American College of Occupational and Environmental Medicine states that the use of narcotics to treat pain has become an "epidemic" in the U.S. and that there are preferred, alternative treatments doctors should use before turning to more aggressive methods.
Colorado's system
In the 1990s, programs specializing in pain treatment proliferated, as did the use of opioids as a primary choice for pain relief. In Colorado, state guidelines mandate that doctors treating patients covered by workers' compensation insurance should use NSAIDs, nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen, for pain relief before turning to narcotics. When doctors do prescribe narcotics, they should only provide a three- to 10-day supply to their patients.
Getting help after an injury
While the study indicates that doctors may not be following proper protocols in treating on the job injuries, it also shows there may be an incentive for providers to deny claims. The WCRI study notes that the average per-claim cost nearly doubled for prescription narcotics from 2001-2009. These costs are generally absorbed by the employers and insurance companies.
After an injury at work, it is important to get the care one needs to fully recover. According the Colorado Department of Labor and Employment, workers injured on the job generally do not get to choose his or her own doctor; unless it can be shown the doctor is providing inadequate care after 90 days. If a provider is refusing treatment that may be helpful to your recovery, it is important to speak with an experienced workers' compensation lawyer. An attorney will advocate on behalf of the injured person in navigating the workers' compensation system.