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Opioid abuse in workers comp: Strategies for employers

Opioid abuse in workers comp: Strategies for employers

As the workers compensation system comes under increasing strain from the nation's opioid epidemic, some workers comp payers are taking aggressive steps to try to combat the problem.

The opioid problem began with about 20 states relaxing laws that had discouraged doctors from treating “chronic, noncancer pain” with these prescription pain medications, an occupational medicine expert said.

The trend, which began in the late 1990s, allowed “extreme permissiveness” in increasing opioid doses prescribed to injured workers, said Dr. Gary M. Franklin, medical director for the Washington State Department of Labor and Industries and a research professor in the departments of Environmental and Occupational Health Sciences and Medicine at the University of Washington in Seattle.

Dr. Franklin made his remarks at last week's Business Insurance Workers Comp Cost Control Strategies virtual conference, which is available on demand at compcosts.

“Within a year or two of the laws...becoming more permissive, we began to notice deaths in the Washington workers compensation system,” Dr. Franklin said. “These deaths (from prescribed opioids) were unintentional poisoning deaths. They were not suicides.”

While Washington state eventually introduced measures to curb doctors' prescription of the pain drugs in noncancer cases, some workers comp payers also have taken measures to discourage overprescribing of opioids.

Oklahoma City-based Hobby Lobby Stores Inc., for example, adopted prescription protocols for flagging and scrutinizing claims involving opioids, said Becky Robinson, the company's assistant vp-risk management.

Hobby Lobby's aggressive efforts have included bringing in pharmacy benefit manager experts to help educate the employer's in-house claims management staff, Ms. Robinson said.

The company also coordinates with its third-party administrator to prevent drug abuse, identify claim problems before they escalate, and hold injured workers and doctors accountable.

Also offering best practices were Julie A. Fortune, senior vp and chief claims officer for Arrowpoint Capital in Charlotte, N.C.; and Michael J. Shor, managing director of Best Doctors Occupational Health Institute in Boston.

The virtual conference also featured:

• A keynote presentation by NCCI Holdings Inc. chief economist Harry Shuford, who spoke about the prospects for the U.S. economy and workers comp market;

• A session on strategies for improving medical outcomes, including quality-focused care, presented by Sedgwick Claims Management Services Inc. President and CEO David A. North and Kimberly George, managed care practice lead for Sedgwick CMS;

• A panel discussion on hot topics in workers comp, such as the impact of the mobile workforce and lagging claim closure rates, featuring several prominent workers comp experts: Mark Walls, assistant vp of claims for Safety National in St. Louis; Thomas Lynch, founder and president of Lynch, Ryan & Associates Inc. in Wellesley, Mass; Joseph Paduda, a principal at Health Strategy Associates in Madison, Conn.; and Business Insurance Senior Editor Roberto Ceniceros, author of the Comp Time blog.

All conference webinars and materials are available on demand at

Business Insurance Associate Editor Matt Dunning contributed to this article.