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Work injuries and narcotic painkillers: the issue of overuse

Narcotic painkillers are widely used in the U.S. This certainly includes use by injured workers in Maryland, as well as other states. Back injuries and other work accidents often leave injured employees in need of pain relief. And physicians frequently prescribe narcotic painkillers, also called opioid painkillers.

A potential concern, of course, is that such drugs are so readily prescribed that they may be abused. A recent survey of workers' compensation pharmacy benefit managers showed considerable concern about the issue. Indeed, the respondents said opioids were the biggest single challenge in workers' compensation pharmacy management.

Most workers' comp pharmacy programs, however, have already implemented programs to respond to issues of overuse and abuse of narcotic painkillers. Such programs typically contain multiple components. But improved follow-up is a major theme.

For example, here are some of the questions that painkiller review programs address.

• Do pharmacists and treating physicians communicate, beyond the mere writing and fulfilling of prescriptions?

• Do physicians who prescribe narcotic painkillers have access to peer review?

• Is there urine testing of painkiller recipients, to guard against the risk of abuse?

• How much education is provided to injured workers on proper opioid dosage?

These are of course only some of the questions that could be asked about painkiller prescriptions and the impact such prescriptions have on injured workers. But they provide a starting point for implementing the right programs.

To be sure, concerns about the abuse of opioid drugs are not the only significant ones involving medication and workers' compensation. The overall cost of drugs is also important, as is the question of how they affect disability duration.

Source: "Painkiller abuse, repackaged drugs top lists of worker' comp pharmacy concerns" Employee Benefit News, 1-14-13

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