Prescription opioids are a major reason for the skyrocketingcost of workers' compensation insurance, as evidence points toharmful consequences from the long-term use of the medication, saysa report from insurance broker Lockton.

In a report titled, “Opioids Wreak Havoc on Workers' CompensationCosts,” Keith E. Rosenblum, senior risk consultant for LocktonCompanies, says the abuse of opiates by injured workers is a majorproblem, both in terms of cost and individual health.

“Prescription opioids are presently the number one workers'compensation problem in terms of controlling the ultimate cost ofindemnity losses,” he writes.

The report estimates 55 to 86 percent of all claimants receiveopioids for chronic pain.

Rosenblum says this is a relatively new phenomenon in the100-year history of workers' comp.

Overdose deaths have increased 300 percent since 1999, andmisuse and abuse of the prescription painkillers was responsiblefor 475,000 emergency room visits in 2009, double what they werefive years ago, he says, according to government data.

Prescription drugs account for 19 percent of total medical spendon an average workers' comp plan, Rosenblum says. Opioids accountfor an average 25 percent of the prescription spend, “and 35percent or greater for claims over three years old.”

While those are the direct costs, there are indirect costs aswell, Rosenblum says, such as workers not returning to work if theyare on the medication more than 90-days as they become eitheraddicted to or tolerant of the drugs. These workers also “suffer amultitude of associated illnesses and debilitating side effectssecondary to drugs' use,” says Rosenblum.

“These losses become exceptionally expensive and very difficultto settle,” he says.

One way to battle this crisis is the utilization of PharmacyBenefit Management (PBM) stewardship reports aimed at informingmanagement of the cost and severity of the drugs on theirprogram.

He says information often supplied to a company's management “isfalling short of telling the whole story” and the PBM are “crucial”to the evaluation of how the workers' comp program isperforming.

An adjuster's job is also very important “to stay on top ofclaims with prescribed opioids, either within the first 10 days ofan acute injury or where these opioids are being prescribed beyond45 days.”

This includes closely monitoring medical reports for illnessesthat could be associated with prolonged opioid drug use; assessmentof the possibility of addiction and closely following patientprogress.

“Above all else, engage and challenge the treating doctor as tothe validity of continuing opioid prescribing, where periodicmedical reports do not indicate progress in work and life skillsfunctions and reduction in pain,” says Rosenblum.