PS2 – The Opioid Crisis Continues
Deaths from prescription opioid painkillers have reached epidemic levels in the past decade. Opioid analgesics are now responsible for more deaths than the number of deaths from suicide, motor vehicle crashes, cocaine and heroin overdoses combined. In 2011, the escalating use of therapeutic opioids showed hydrocodone topped all prescriptions with 136.7 million prescriptions; and all narcotic analgesics exceeded 238 million prescriptions. Improving the way prescription painkillers are prescribed can reduce the number of people who misuse, abuse or overdose from these powerful drugs, while making sure patients have access to safe, effective treatment.
Prescription monitoring and nurse case managers can combat the problem. If a nurse case manager is not already assigned to a lost time claim, the issuance of a prescription to the injured employee for any narcotic should be an automatic trigger to assign that claim to the nurse case manager. If a nurse case manager is already assigned to the claim, the nurse should discuss with the treating physician the use of short-acting opioids rather than long-acting opioids. Careful monitoring of the opioid use by both the pharmacy benefit management company and the nurse case manager is essential to holding down the cost of the claim and preventing opioid addiction. Workers’ compensation stakeholders must confront the inappropriate use of narcotics in the system. Injured workers are suffering and employers are paying for the unintended consequences of these drugs.