This session at the 2015 WCI Conference discussed forward thinking approaches to early intervention and how to effectively address claims with long-term exposure to narcotics.
The speakers included Teresa Bartlett, M.D., Senior Vice President, Medical Quality, Sedgwick, Michael Gavin, President, Pruim, and Tron Emptage, Chief Clinical Officer, Helios.
Dr. Bartlett started this session by presenting the group with some startling statistics.
80% of opioids dispensed in the world are in the U.S.
99% of all hydrocodone dispensed in the world is dispensed in the U.S.
Education is key regarding narcotics. The injured worker needs to be cognizant of all side effects and aware of any information pertaining to these prescriptions.
What would best practices be regarding narcotics and opioids?
Don’t do it! But in all seriousness the first question needs to be does the injured worker really need these prescriptions and are they aware of all the side effects. One item that is not utilized enough is the risk assessment. This should be given by the physician to look for trends or past traits or habits that could lead to use to narcotics before they prescribe certain medicines. Narcotics should be prescribed as a means to an end. If there is an entrance, there needs to be an exit strategy. The decision should be ultimately up to the injured worker, but it is a duty to give them all the information possible.
What is new in narcotic management?
The bad is genetic testing. This really isn’t appropriate in workers’ compensation. Currently it is just creating more bills but this will be more prevalent in the future.
The good is emphasis in psychosocial management. The focus should not be on the medicines and prescriptions but on the pain itself and why is the injured worker experiencing the pain.
Currently, there is a decline in the use of opioids, it is small. But this is still progress in the right direction. In order to keep this decline, it was suggested by a panelist that we need to get the American Medical Association to require pain management education. Presently, there is not enough education for pain management. There should be programs in place that take a deeper look into narcotics and opioids and their effects on the injured worker. Another panelist suggested there need to programs in place that require a physician to register to be able to prescribe opioids and narcotics and registration required for an injured worker to fill that prescription.