There has been a recent concern by private organizations and the government regarding the way that employees are treated for illness and injury. Available data indicates that there has been an increase in prescription pain medication use and abuse. Over a thousand people are being admitted daily to emergency departments due to the misuse of prescription opioids and this deadly trend is leading more workers to debilitating addictions to powerful narcotics. One area where serious musculoskeletal and other severe injuries are common is within the Workers’ Compensation system.
Every year, there are millions of work-related injuries and many of these injuries leave the employees with chronic pain or disability. Although many medical professionals have historically recommended a combination of powerful pain relievers and bed rest for these kind of injuries, there has been a continuous rise in the number of deadly prescription opioid overdoses and concerned citizens are presently advocating for a change in the way these powerful drugs are prescribed.
How Many Workers get Injured at Work?
According to the US Bureau of Labor & Statistics, in 2015 there were about 2.9 million reported nonfatal workplace injuries and illnesses by private employers; of which 2.8 million were injuries. That is a rate of about 3 cases per 100 full-time employees. Injuries stemmed from a variety of workplace accidents; including falls, being struck by an object, getting caught in/between machinery, equipment or objects, and electrocution.
The Problem with Opioid Prescriptions
In 2013, providers wrote about a quarter of a billion opioid prescriptions; which is sufficient for every American adult to have their own bottle of pills. The most common opioids that were prescribed include Methadone, Oxycodone, and Hydrocodone. These drugs were prescribed for workers in severe pain. Chronic pain is defined as the pain that lasts for over three months or pains that last beyond the time of normal tissue healing. In Workers’ Comp cases, the prescription of opioids is generally related to chronic or traumatic injury.
Opioids can act as a double-edged sword. Patients who use opioids to gain relief from pain for a long time may gradually become physically dependent on these substances. As their tolerance to the effects of these drugs increases, they may discover that they need more and more of these medications to gain pain relief. This becomes a dangerous cycle that results in addiction and may lead to overdosing.
According to the National Safety Council, prescription drug addiction has three cycles:
- In the first cycle, the patient is prescribed a legitimate prescription for the injury
- During the second cycle, patients begin to misuse these substances
- Finally, in the third cycle, they wind up with a full blown addiction
Fighting the Epidemic of Abuse
According to a 2013 interview with Rochelle Henderson of Express Scripts, physicians who do not routinely treat work-related injuries may be less familiar with the research associated with narcotic use among injured workers, as well as the clinical guidelines for the quantity and dose. They may therefore be more likely to prescribe larger amounts of narcotics to injured workers than their peers. Prolonged use or abuse of opioids by workers can lead to higher medical costs for employers and insurers.
There have been several efforts by the government to curb the growing problem of prescription opioid abuse. For example, in 2016 California introduced a new Workers’ Comp opioid analgesic (painkiller) treatment guideline which provided a detailed description of the appropriate use of opioid medications as a part of the general multidisciplinary treatment regime for the following classes of pain:
- Acute pain
- Sub-acute pain
- Post-operative pain
- Chronic non-cancer pain
In 2016, the Food and Drug Administration (FDA) issued a statement that strong prescription opioid painkillers would require a “black box warning” regarding the high risk of addiction, overdose, abuse, and/or death. A black box warning is the strictest warning put in the labeling of prescription drugs when there is reasonable evidence of an association of a serious hazard with the drug.
The CDC also released a guideline in 2016 to caution and educate doctors on prescribing opioids for chronic pain. The aim of this guideline is threefold. It was written to address when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow-up, and discontinuation; and assessing risk and addressing harms of opioid use. Hopefully, efforts such as the aforementioned will help to reduce the number of addicted opioid users and to help educate injured workers of the potential risks involved with opioid prescriptions.
Alternatives to Opioid Treatment
One of the alternatives to opioid prescription is early intervention therapy. This approach makes use of immediate massage therapy, chiropractic treatment, or physical therapy to increase mobility and reduce healing times. By shifting focus to functional recovery, patients may be less likely to develop chronic pain that needs prescription opioid pain medication.
Other forms of treatment for dealing with pain are also currently used as alternatives to opioid prescriptions. These practices include acupuncture, hypnotherapy, and aroma therapy. In the end, choosing an alternative to opioids for pain could be the difference between pain relief and addiction.