The opioid epidemic is affecting more than you may realize. Here’s what employers can do to keep their employees safe.
By Bethany Bourgault
No one wants to find out that one of their employees overdosed. Certainly no one wants to find out it was on an opioid they were prescribed during a workers’ compensation claim.
Incidents like this are becoming more and more common. Nearly two million Americans are currently abusing opioids, and over 16,000 die each year from prescription overdoses.
On September 12, 2019 four experts – Eric Chase, Esq. of Wolff, Goodrich and Goldman; Kevin Tribout of OPTUM Workers’ Comp., Pharmacy Benefit Management; Devon Fik of NCAComp, Inc.; and Cindy Bush of OneGroup – met in the Education Center at OneGroup Center to address a full house about opioids in the workplace.
“People ask me all the time, ‘who do you think really was on the opioid issue first?’ And my answer always is, ‘workers’ compensation,’” said panelist Kevin Tribout. “70-75% of the medications prescribed in workers’ compensation are to treat what? Pain. And what do you use to treat pain? Opioids.”
Businesses pay double when the opioid crisis strikes one of their employees. First they pay for the claims. Opioids are expensive medications. Then they pay for the loss of a productive employee. No one wins when an employee shows spotty attendance, loss of focus, works under the influence or ceases attending at all.
“This isn’t a drug addict problem. This isn’t a street problem,” said Cindy Bush. “These people are running heavy equipment, driving powered industrial vehicles, making split-second decisions about the quality of your product.”
When it comes to risks like this, employers can take action.
Getting in touch with an insurance carrier, TPA or Pharmacy Benefit Manager (PBM) is a good first step. Those professionals are ready to help with the rest of the process. The employer and their claims team can then work with doctors and legal professionals to conduct an Independent Medical Examination (IME) and put the employee on a weaning plan.
Weaning is a long process. Many weaning plans take six months or more. However, when conducted properly, these plans can save employers millions in claim costs, workplace risks and productivity costs.
Reasonable Suspicion
Taking action like this requires employers to first have a justified, reasonable suspicion that their employee has become addicted. Several clues, or “triggers,” may be used to justify this suspicion. These could be:
- High dose opioids (High Morphine Equivalent Dosage (MED))
- High monthly pharmacy costs
- Long term use of opioids
- Not recommended use of off-label medication
- Redundant therapies
- Dangerous drug combinations
- Medical Marijuana
- Multiple prescribers
- Narcan prescription
Source: NCAComp, Inc. Prescription Facts
Recognizing the ability to intervene sometimes involves a cultural shift in the workplace.
“You need to understand where your company stands on this issue. Do you see this as a disease, or as a moral failure?” said Cindy Bush.
Hope for the future
A new drug formulary was adopted by New York State on June 5, 2019, and is expected to bring some relief. The formulary limits the quantity of opioid medication doctors can prescribe for certain treatments and limits the types of medications they can freely prescribe in the first place. Beginning in June 2020, doctors will need prior authorization on a case by case basis to prescribe narcotics and opioids for any longer than seven days and for any case beyond 30 days post-new injury.
Even before that, however, panelists agreed that one of the best things employers could do about the issue is communicate.
“Keep raising the level of conversations,” said Bush, “Don’t hesitate to question things. Don’t hesitate to ask for reports… Bravely factor addiction and these drug issues into your return to work plan.”
As for dealing with your workforce, “stay connected to your employees,” said Bush. “Be there for them. Be the calm in the storm during their claim. Because work, believe it or not, is the solution to so many people’s problems.”
Bethany Bourgault is publications and communications coordinator at OneGroup. She can be reached at 315-413-4498 or [email protected].
This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.
Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.
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