"It began in late 2000 when Congress passed and the President signed into law legislation that declared a 10-year period beginning January 1, 2001 'the decade of pain control and research.' Congress felt the medical community was not adequately addressing pain," said Dr. Teresa Bartlett, senior vice president and medical director for Sedgwick Claims Management Services.
Bartlett was joined by Sean McDaniel, director of Claims Management for Veolia Environmental Services in Lombard, Ill., during a session at the recent National Workers' Compensation and Disability Conference® & Expo, produced by LRP Publications.
"Where there is good intent and hope, we work with addiction specialists and rehab," Bartlett
Others truly want to get back to some sort of normalcy and don't want to deal with the pain, and the pain that results from needing these drugs to function," Bartlett
That's the first step," Bartlett
"There are times a person is enough of a concern that an employer can say, 'I don't need to know about it, but I'm worried about your fitness for duty.
Based on these factors I need you to go and get an assessment and I need a note from your physician that you are able to work safely.' I've seen those be very successful."
While employers need to tread carefully, there are additional steps they can take to address the issue at the beginning.
explains, approximately 40 percent of the population has a negative reaction to opioids.
Working in concert with the treating physician is vital.
"We want to manage that first script with a few days supply, so if they have a bad reaction they don't have a lot of unused pills sitting around," she
Employers can request the physician check in with the patient to see if the prescription should be continued beyond the initial few days.
"We hear our clients' employees say, 'I couldn't cook for my kids but now I can.
I can now walk my dog a block.' It's little improvements," Bartlett
"If we don't see those improvements we really want to stop the script by partnering and communicating with the physician.
There is no therapeutic value here so let's not continue.
also suggests the use of physician/patient contracts before opioid treatment begins.
Physicians can also be directed to state prescription monitoring programs to see what medications the patient is taking, the number of pills prescribed, and the dates the prescriptions were filled.
"That can be a tool to help physicians understand if their patient is going to other places seeking pain medication," Bartlett
"If you live close to a border, you might want to check the next state as well."
Finally, the use of pharmacy benefit managers can help target injured workers who could become opioid abusers.
"We get alerts at the claim examiner desk level telling us 'here is a script for a narcotic.
Here is a second script.
You might want to take action,'" Bartlett