There’s a lot of myth and fiction surrounding opioid abuse, addiction, and dependence, a situation that leads to misunderstanding the drivers, and solutions to the problem. With NCCI reporting narcotics account for a quarter (about $1.4 billion) in work comp drug spend, it’s critical for adjusters, clinical staff, and execs alike to understand the issue.
There’s a CEU course entitled “Understanding Opioid Addiction and Dependence: Therapeutic Options to Improve Patient Care” that’s free for the taking. Originally developed for pharmacists, anyone can access the materials and take the tests. If you can’t take the course now, make sure you click on the link and print out the flow chart illustrating the appropriate path for screening, diagnosis and treatment of opioid dependence, print it out, and stick it up on your wall. Especially if you’re an adjuster.
A reader asked why this has become so important an issue. Several reasons.
1. Most claimants on opioids aren’t going back to work driving the school bus, operating the printing press, or moving patients in the nursing home. Getting claimants off opioids is the first step to getting the claim closed.
2. Drug costs are going thru the roof, driven in large part by overuse of narcotics.
3. There’s very little medical evidence to support the long-term use of opioids for individuals with musculoskeletal injuries. Yet many claimants are on opioids for more than three months.
Here’s a couple takeaways to get you thinking…
– Among individuals 12 years or older in 2008-2009 who used pain relievers nonmedically in the past 12 months, 55.3% acquired the drug from a friend or relative; 17.6% reported that it was prescribed by a single physician
– Evaluating opioid dependence requires an understanding of the difference between addiction, tolerance, and physical dependence.
– the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, defines substance dependence, which equates with addiction, as a maladaptive pattern of substance use over a 12-month period with evidence of 3 or more of the following
(anything here sound familiar?):
- Drug tolerance
- Withdrawal symptoms
- The amount or duration of use is greater than intended
- The patient repeatedly tries unsuccessfully to control or reduce substance use
- The patient spends much time using the substance, recovering from its effects, or trying to obtain it
- The patient reduces or abandons important work, social, or leisure activities because of substance use
- The patient continues to use the substance despite knowledge that it has caused ongoing physical or psychological problems
What does this mean for you?
Dealing with opioid abuse requires understanding the causes and solutions. If you handle claims or deal with injured workers, this is well worth your time.
