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Monitoring Opioid Use of Workers’ Compensation Claimants

Drug overdoses have become the number-one cause of unintentional death in the United States. The main cause of overdose deaths is the opioid epidemic.  

Opioids include prescription opioids, heroin and fentanyl. Doctors may prescribe opioids such as oxycodone, hydrocodone, morphine and oxymorphone, when certain workers’ compensation injuries occur. The most common injuries are back, shoulder and knee injuries.  

Opioids are prescribed to reduce pain in patients and may act as a depressant of the central nervous system. Users of prescribed opioids may eventually develop an opioid use disorder, and misuse the prescription by taking it longer than necessary. Misuse of opioids can in turn lead to a drug overdose which can be fatal. 

These actions are recommended by the Centers for Disease Control and Prevention to prescribers when providing opioid prescriptions: 

  • Medical providers should reevaluate their prescribing habits. 

  • Opioids should be used only when recommended and limited prescriptions should be provided. 

  • Users on chronic opioid treatments should have periodic evaluations to assess the risk of opioid side effects. Non-opioid therapy should be considered for chronic pain patients. 

The SC Municipal Insurance Trust works with its pharmacy provider, Corporate Pharmacy Services, to implement measures to monitor the opioid use of its workers’ compensation claimants. The measures include these: 

  • Requiring prior approval from the SCMIT claims adjuster before prescriptions can be filled. 

  • Providing yearly reports detailing prescription drugs and usage. 

  • Utilizing the best practices to help injured workers with chronic pain while lessening the likelihood of opioid addiction and abuse. 

  • Monitoring guidelines for compliance with the supply of opioid medication. 

  • Providing letters of necessity to treatment providers. 

  • Letters identify the morphine equivalent dosage being prescribed to claimants and compare it to the CDC opioid guidelines. 

  • Recommendations for opioid tapering are provided when dosage is above the recommended guideline. 

  • Complete drug utilization reviews to determine the medical necessity of prescriptions. 

Doctors will continue to prescribe opioids, so it’s important for employers to understand them and how they can impact the workplace. Here are some recommendations for employers:  

  • Learn about opioid misuse and disorder. 

  • Recognize signs of opioid impairment or overdose. 

  • Educate employees on the risks of opioid use. 

  • Implement drug related policies and procedures. 

  • Support employees struggling with opioid misuse. 

  • Obtain and add naloxone to first aid kits, and train employees how to administer naloxone. 

Naloxone is reimbursable under the SCMIT fire service and law enforcement officer safety grants. 

For additional information about the opioid crisis, visit the website of the National Safety Council.