Workers' Comp Woes: Injured Workers and Opiate Addiction

A workers' compensation insurance holding company has established a narcotics program to address the problem of injured workers developing opiate addictions that make them unable to return to work in a timely fashion – or at all.

According to Accident Holdings Inc., opiate addiction is a "major problem" for the workers' comp industry, and one that is exasperated by new drugs being brought to market and state regulations that lack controls.

An estimated 55-85 percent of injured workers nationwide receive narcotics for chronic pain relief. Opioid medications are now being prescribed at higher dosages in pure form and are routinely making their way into the hands of injured workers without the proper controls, regardless of the health risks, Accident Holdings said.

"The extent of the issue was not fully realized until we linked our pharmacy data to our claims data," said Jeffrey Austin White, director of Medical Management Practices and Strategy for Accident Fund Holdings. "In hindsight, it appears we were focused primarily on monitoring drug cost, along with the rest of the industry, rather than the impact of the drug on the injured worker."

The narcotics program has been under development over the past six months at Accident Fund Insurance Company of America, a subsidiary of Accident Fund Holdings, and will be expanded to all of Accident Fund Holdings' companies. The primary program components include early detection software, activity driven workflows, and peer-to-peer intervention strategies – all with the goal of helping injured employees get back to work sooner.

"We are extremely happy with our preliminary results," said Paul Kauffman, RN, director of Medical Programs for Accident Fund Insurance Company of America. "Over 70 percent of our providers have been willing to adjust treatment protocols and monitor the use of opioids by our injured workers. Of the over 200 injured workers that were touched by the program during the introductory period, over five percent have been weaned from narcotics and are already back to work."

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