Opioid Abuse in Workers’ Compensation: What the Medical Tourism Industry Needs to Know

One workers’ compensation topic that I have avoided discussing so far, given that the tagline of my blog is about implementing medical tourism into workers’ compensation, is the issue of opioid abuse in workers’ compensation.

Many articles and blog postings have been written describing the problem and the ways in which insurance companies, third party administrators, claims management firms, pharmacy benefit management firms, brokers, claims and risk managers, state and federal government agencies, and other interested parties are trying to get a handle on this problem.

It is a very complex and complicated issue, and one that has many in the workers’ compensation industry concerned because it drives up medical costs for claims, adds to the number of claims filed not only due to an injury, but to the abuse and addiction it engenders. It also impairs workers who then get injured again due to the effects of the medication, and it lowers productivity and prolongs the time employees take to return to work.

Business Insurance issued a White Paper on the subject last year entitled, Opioid Abuse & Workers’ Comp. In the paper, the authors describe the growing use of opioids that create abuse issues, the multiple factors causing the persistent problem, the rise of employer costs as abuse widens, the mix of strategies being used to combat this problem, and how to track selected metrics that are being used to support the goals workers comp managers establish to reduce abuse.

It so happens that some of the individuals who are quoted in the paper are people I know from other blogs, such as Joe Paduda, or are one of my LinkedIn connections, or I knew when I did my summer internship at the Third Party Administrator, Broadspire’s Sunrise, Florida office as part of my MHA degree program requirements in 2011.

One of the projects that I worked on while at Broadspire dealt with the dispensing of drugs by physicians, which is another important problem in workers’ compensation, and is related to opioid abuse, since most of the drugs prescribed in workers’ comp are the Schedule drugs being abused the most in the US. What I found was that the most serious problem of prescribing drugs was in California, and was not confined to physicians alone, but to pharmacies as well. Florida was the other state that had the most drugs prescribed by pharmacies or physicians. Time did not allow me to look at the other states of the country.

While not wanting to get too deep into the subject, I believe that it is important for those in the medical tourism industry to be cognizant and aware of the problem. Those who would like to pursue implementation of medical tourism into the workers’ compensation system in the US should realize that such a problem exists, so that in the future, if a self-insured employer or commercially insured employer should send one of their injured workers abroad for medical treatment of a work-related injury, the facilitator and the staff of the hospital where treatment is provided, knows that abuse of pain medication is a rampant problem among US workers’ compensation claimants.

This is even more incumbent upon those who, as I mentioned in my last post, What Role Can Medical Tourism Play in Physical Therapy and Rehabilitation for Workers’ Compensation?, might want to get into the area of physical therapy and rehabilitation, since the goal of rehab and therapy is to get the patient back to work faster, and one of the side effects of abuse is prolonged disability.

This is a serious issue for the workers’ compensation industry at the present time, and before medical tourism can be properly implemented, it is advisable that it is taken just as seriously in the medical tourism industry as well.