Vicodin. Percocet. Percodan. OxyContin. Fentanyl. Tylenol with Codeine. These are just a few of the prescription painkillers known as opioids on the market that injured workers may be taking with the advice of their doctors. But how many of those workers can stop using the painkillers as they return to work?
According to recent media reports, opioid abuse among injured workers is growing, partially as a result of over-prescription by doctors who don't want to see their patients in pain. Although the issue is widespread across all industries, two new reports from CNA, the eighth largest commercial insurance writer in the U.S., find that the construction and manufacturing industries are particularly at risk for such abuse. The reports—Construction: Prescription Opioid Abuse and Manufacturing: Prescription Opioid Abuse—use CNA claim data to provide risk management strategies to address this issue.
"The opioid abuse epidemic is taking a toll on many aspects of the U.S. economy, including businesses' workers' compensation losses," said Bill Boyd, senior vice president, Risk Control for CNA. "The delay of returning injured employees to work can affect operations and, therefore, negatively impact a company's bottom line. Opioid abuse is a real and emerging risk for businesses to consider, and through these Risk Outlooks, I hope our customers will learn solutions to avoid return-to-work pitfalls."
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Using claims data to detect trends
Most prescription drugs involved in abuse and overdose come from legally obtained prescriptions, the reports point out. After the drugs are validly prescribed, they are frequently diverted. Drug diversion is the process of either sharing drugs with people who don't have prescriptions or are illegally selling them on a secondary market.
CNA says that an estimated 15.1% of construction workers and 6.5% of manufacturing workers have engaged in illicit drug use. The company uses its claim data to analyze the industry averages against potential opioid abusers and post-accident spend. The data allows CNA to categorize employees into three groups—low, medium and high—by their probability of painkiller abuse. In all cases, the incurred costs for injured employees flagged for potential painkiller abuse was much higher compared to employees for low probability of abuse. At three years of follow up, claimants who had been flagged for high potential for opioid abuse resulted in 3% higher costs compared to claimants who were not similarly flagged.
"By partnering with leading construction and manufacturing associations, we have seen increased concern about prescription opioid abuse, as well as how it increases worker injuries and businesses' losses," said John Tatum, senior vice president, Middle Market. "Many of these associations are developing programs to educate their members about the issue in order to provide the tools, training and resources they need to address opioid abuse in their own workplaces."
(Photo: Shutterstock/Rawpixel)
Prevention strategies
CNA recommends that employers implement the following strategies to help combat and prevent opioid abuse.
1. Educate employees about responsible prescription opioid use, especially about the potency of these drugs, how they work, how they interact with other drugs and how they can become addictive.
2. Understand and communicate the risk factors of opioid abuse, including the problems raised by doctor shopping and physicians directly dispensing opioids, instead of obtaining them through a pharmacy.
3. Provide strong social support support and safe return to work to injured employees from fellow workers, the immediate supervisor and management.
4. Communicate treatment options, including counseling, behavior modification and pharmaceutical treatment.
5. Ask yourself and your physician questions about treatment guidelines and the plan for discontinuing opioids to treat acute pain, for example.
To access the studies, available for download on request, visit Construction: Prescription Opioid Abuse or Manufacturing: Prescription Opioid Abuse.
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