Posted By Pablo Conde on June 6, 2014 in Business Insurance
Pablo Conde

What are Opioids and What Do They Have to Do with Business Insurance?

What are opioids and what do they have to do with business insurance
Opioid addiction can cost businesses money

There are a number of challenges faced by workers’ compensation managers as they deal with shifting health care concerns in the United States. One concern that’s being raised is the abuse of opioids by people who file workers’ compensation claims.

What Are Opioids?

An opioid, one of the world’s oldest known drugs, is a chemical similar to morphine. That is, it’s an analgesic and its primary purpose is to relieve pain. People who take opioids experience a decreased perception of pain and an increase in tolerance of pain. Side effects of the drug include respiratory depression, sedation, and constipation. Opioids can also produce a feeling of euphoria, which is why some people take the drug recreationally.

Opioids are powerful pain relievers

The Problem

The problem for workers’ compensation managers is that sometimes, when people get injured on the job, they are prescribed opioids for pain relief. This is certainly understandable and should be welcome by everyone.

However, in many cases, the claimant begins to enjoy the drug so much that he or she wants to keep on taking it. Sometimes, claimants even become addicted to the drug. 

What are the effects of excessive opioid use? First of all, the claimant’s productivity tends to decrease while under the influence of the drug. So, the employer is stuck with a sub-par employee during that time.

Also, since the claimant was injured on the job, the workers’ compensation insurance company pays the prescription costs for those opioids. This also affects the employer because these claims will end up costing the employer more in workers’ compensation insurance premiums.

What Can Be Done?

What are some steps that workers’ compensation managers can take to ensure that the system is not abused? For starters, the company can put in place a program to educate employees about the dangers of opioids. People who take pain relievers knowing that they have an addictive quality will likely take them more conservatively (i.e., only when absolutely necessary).

Another technique is to identify those claimants who have been long-term users of opioids. Management should develop a program to end usage of the drug for those employees who have been taking it for more than 60 days.

Random drug testing is another way to check for opioid abuse. Drug testing is usually thought to include only checks for those drugs which are illegal. However, legal drugs, such as opioids, can have an impact on employee performance as well. Responsible employers will screen for these drugs, too.

Finally, the pharmacy benefits management program should be part of a Drug Utilization Review Program (DUR). That program will trigger clinical review of prescribed medications when use has fallen outside prevailing standards. 

Opioid abuse in workers’ compensation claimants is costing businesses money. These costs will almost certainly transfer to customers if they’re not managed properly. Fortunately, they can be managed with proper oversight.