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DANA POINT, California — Workers compensation professionals need a comprehensive strategy to address the risk of opioid abuse among injured workers, speakers said Thursday at the 2014 California Workers' Compensation & Risk Conference.
One reason the workers comp industry needs to address opioid addiction is that regulators are now paying closer attention to the issue, said Roman Kownacki, medical director, Occupational Health Services for Kaiser Permanente Northern California.
“We are seeing the reclassification of certain medications,” Mr. Kownacki during a panel discussion at the meeting in Dana Point, California. “Vicodin will soon be a Schedule II drug.”
The U.S. Drug Enforcement Administration last month said that Vicodin and other hydrocodone combination drugs will be classified as Schedule II controlled substances as of Oct. 6. Schedule II drugs cannot be refilled under the same prescription, whereas Schedule III medications — the current classification for Vicodin — can be refilled up to five times, with prescriptions expiring after six months.
In addition to the negative health impacts of opioid addiction, Mr. Kownacki said the propensity of opioids to function as a gateway drug to heroin was troublesome, noting that efforts to restrict use of prescription painkillers has driven up their price on the street and coincided with a surge in heroin use nationally.
Heroin is a cheaper alternative,” he said, noting that intravenous use of heroin heightens the risk for other health problems. “If you follow the chain of progression, it's possible for somebody to get hooked on opiates from a workers' compensation injury and end up with H.I.V. or hepatitis.”
Patti Williams, risk manager for the city of Huntington Beach, California, said any attempt to address the opioid issue would need to involve educating both doctors and patients. “It's a small percentage of doctors that prescribe a large percentage of opioids,” she said.
Ms. Williams said a team-based approach was best to ensure that patients don't become addicted to their prescriptions. “A good nurse case manager goes a long way,” she said. “You get a lot of bang for your buck.”
LAS VEGAS — The impact of opioids should be measured regularly, but it's not sufficient to ask injured workers to subjectively evaluate their pain and functional improvement, Dr. Kurt Hegmann said at this week's Disability Management Employer Coalition's conference in Las Vegas.