The Opioid Crisis: What Employers Can Do

Recently released Opioid Epidemic statistics from 2017 reveal that the country continues to convulse in the throes of this public health crisis. New laws aimed at addressing the issue are coming out of both state and federal sources, and even the tech industry is focusing more attention on using digital devices to prevent or reduce the need for opioid pain medications.


The most important participants in the fight against the epidemic, however, may well be the nation's employers, whose workers are most often the recipients of the drugs. By understanding how on-the-job injuries have driven the rise in opioid prescriptions, many employers can make subtle but significant changes in how they manage their worksites and injury responses so that their injured workers can recover in spite of or without the use of the addicting pain medications.


No End in Sight ...

Despite the recent legal and statutory developments offering enhanced guidance and support for opioid addiction sufferers, the number of victims continues to rise. In 2017, more than 72,000 Americans lost their lives to their opioid addiction, bringing the total estimate of premature deaths attributed to opioids to over 670,000 since 1999. (Compare that to the total 58,220 soldiers lost during the almost 20-year war in Viet Nam.)


Every day adds another 150 people to the opioid death total.


... But Multiple Avenues of Attack

Both governments and industries are focused on providing solutions:

  • In September of this year, U.S. Senate released its proposed Opioid Crisis Response Act (OCRA) of 2018, which attempts to coordinate the prevention and response efforts of several federal agencies. Suggested avenues of attack include reducing the supply of (legally produced) opioid medications; mandating stricter packaging and prescribing options that reduce the likelihood of over-prescribing, and the development of more effective treatment options and resources, to name just three.
  • Technology developers are also interested in turning the opioid tide. One common focus of several technology companies: utilizing electronic health records (EHRs) to track the prescription and use of opioid-based medicines. Data collected at several points of a patient's treatment cycle can help track how each individual patient is utilizing those medications and, in some cases, whether they needed an opioid prescription in the first place.
  • Approaching the crisis from a different angle are the nation's insurers, who are picking up the tab for millions of dollars of both injury and addiction treatment activities. Further, those metrics indicate that American's employers may hold at least one key to truly reducing the number of opioid addicts and the consequent suffering of both them and their communities.

While it is almost impossible to identify with certainty the percentage of opioid-affected injured workers that make up the whole of the opioid-affected population, at least one group puts that number at 60 percent. The International Risk Management Institute (IRMI) estimates that employers spent more than $25 billion on opioid prescriptions in 2007 and extrapolates that sum out to the equivalent of over $50 billion in 2016. If that total was reduced by even a small percentage - meaning that if the number of workplace injuries went down and/or the number of opioid prescriptions for workplace injuries went down - then the number of opioid addictions should also fall correspondingly.


Ergo, the IRMI suggests that America's employers, as a group, could do more to reduce the number of both injured and addicted workers, a premise which begs the question: How do they do that?


What Employers Can Do to Prevent Opioid Use and Abuse

Considering the strong connection between a boss and an employee, there are several opportunities within that relationship where the employer can avoid the risk of an employee's potential future opioid addiction:


1. Prevent injuries in the first place

Even with strong workplace safety rules in place, many employers fail to maintain those high standards throughout their worksite or shop. Injuries caused by over-exertion, falls, and inadvertent contact with machinery are often completely avoidable, requiring only improved oversight and attention to safety details. Engaging workers in the safety-related conversation also goes a long way to raising awareness about dangers and preventative actions.


2. After an injury has occurred, be alert to corresponding opioid prescriptions

Not every workplace injury requires an opioid prescription and not every worker should get one, regardless of the extent of their injury. The Traveler's Companies devised an "Early Severity Predictor" algorithm to measure the likelihood of an injured person developing chronic pain, one of the main drivers of opioid addiction. According to Traveler's, the algorithm identifies the types of injuries that might predispose patients to develop chronic pain, such as lower-back pain (#1), knee and shoulder injuries. It also tracks physicians who are more likely to prescribe opioids.


By identifying these 'sensitive' workers early in their treatment phase and before extensive medical interventions are carried out, physicians can prescribe non-opioid pain relief and avoid the risk of opioid addiction altogether.


3. Monitor pain treatment protocols

Despite the best of intentions, injured workers frequently require pain medications and, in many cases, the best medication for the purpose is an opioid. In these cases, employers can use their on-staff or insurer-provided Case Managers to monitor the patient's opioid use and deflect them if they indicate a growing addiction. These health professionals are trained to evaluate the impact of opioid use on recovery activities and to identify alternatives that will both address the pain concern while better facilitating the recovery effort.


Research reveals that investments in Nurse Case Managers in workers’ compensation cases resulted in reductions in worker treatment costs.


4. Follow all recommended protocols

There are many other recommendations for employers who are involved in the medical cases of their injured employees, all of which are aimed at reducing the opportunity for injury, maintaining vigilance over treatment activities and actively seeking alternatives to opioids when appropriate. Perhaps the most critical recommendation: make sure that treating physicians stick to the Opioid Prescribing Guidelines as issued by the American College of Occupational and Environmental Medicine:

  • Obtain informed consent before prescribing an opioid for pain relief by ensuring the patient understand the reasons for the prescription and the dangers posed by the medication.
  • Obtain a full medical history to alert the medical professional to potential 'sensitivities' that might predispose the patient to addictive behaviors. Update the historical screening if the prescription is to last beyond two weeks.
  • Avoid co-prescribing benzodiazepines with opioids.
  • Perform routine urine monitoring.
  • Cease opioid usage as soon as the patient achieves a meaningful functional recovery.


America's battle against opioid addiction is ongoing and requires the attention and effort of every group that is, or could possibly be, affected by it. America's employers are apparently on the front lines of the battle field and, by accepting that challenge and making incremental efforts to reduce its impact in their offices and worksites, they can play a big part in how that battle will eventually be won.