National Underwriter - January 23, 2012

BY SHERRI HICKEY

OPIOID MISUSE and abuse is a huge problem in the Workers’ Compen- sation field, contributing to an increase in deaths and medical costs.

Meant to be prescribed after major surgeries or major trauma, these drugs are intended for short-term use or end-of-life cancer pain. “Short-term” is meant to signify a span of a few days or weeks—not years, as the current trend indicates.

The Institute of Medicine has reported that chronic pain affects more than 116 million American adults—more than the total affected by heart disease, cancer and diabetes combined—and costs up to $635 billion a year in medical treatment and lost productivity.

It is extremely common to see injured workers abusing opioids or pain relievers, and these drugs also cause a variety of side effects that end up becoming part of the Workers’ Comp claim.

Treatment for these side effects results in more drugs being prescribed.

According to our claims data, some injured workers are taking 20 to 30— perhaps 40 or more—pills a day. This can include different pain medications, laxatives and sleeping aids.

One of the major issues with opioids is the lack of regulation and oversight from So what do we do to address opioids in Workers’ Comp? Partnering with a good pharmacy-benefit manager (PBM)

is a start. Your PBM should focus on appropriate utilization of pharmacy, not just the price paid per prescription fill. It is critical that utilization—not the cost per fill—becomes the cost-driver.

Claim handlers also must consider the psycho-social factors that could lead to prescription misuse. Does the injured worker have a history of addictive behavior, such as smoking or alcohol abuse? Such individuals are at greater risk for developing an addiction to opioids.

According to the CDC, about 40 people die each day in the United States from prescription-drug overdoses. Most of these deaths are associated with opioids. The time for action on this issue is now. NU

 Sherri Hickey is Director/Medical Management with Safety National in St. Louis, Mo.

Man’s Best Friend—or Missile?

Image by Thinkstock

BY CHRISTINE BARLOW

IT HAS LONG BEEN said that “dog is man’s best friend,” and many people feel that way about their family pets. They are so attached to their pets, in fact, that they frequently take them along with them in the car—and it’s not just a ride to the vet. They’re taking dogs to dog parks, day care and even play dates with other dogs.

This is all well and good, until one thinks about the distraction that having a dog in the car brings.

A survey of drivers who travel with their dogs showed that drivers admit to petting their dogs; using hands or arms to hold dogs in place while braking; using hands to keep dogs from climbing into the front seat; allowing dogs to sit on their lap; and feeding dogs treats while driving.

In addition to the driving distraction
that Fido presents when he is a passenger in
the car, there is also another safety hazard.
In an accident, Fido becomes a flying
missile, injuring himself and others as he
bounces around the car. In an abrupt stop,
Fido will keep moving at the speed the car
was traveling. Take a 40-pound dog moving
at 60 miles an hour, and the physics of the
situation get ugly. The driver, passengers
and dog may all be injured.