Workers’ Comp Claims and Opioids in Maryland
When a worker is injured on the job, Maryland’s workers’ compensation system covers medical care and other WC benefits. This coverage includes prescription medications, including opioids. Doctors often prescribe opioids for treatment of pain after an injury at work. However, with the growing opioid epidemic, the question of whether addictive pain medications are being over-prescribed for injured employees is becoming an issue.
According to the Workers’ Compensation Research Institute (WCRII), seventy-five percent of injured employees are prescribed opioids. The Journal of Addictive Diseases reports that over one-third of injured workers with chronic pain are addicted to pain medication. Even though some studies show a slight decline in opioid prescriptions in workers’ comp cases, the opioid epidemic continues to be an issue in many workers’ compensation claims.
Below is a brief discussion by our Maryland workers’ compensation attorneys of some of the efforts to combat opioid addictions related to workers’ comp claims in Maryland and throughout the United States.
What are Opioids?
Opioid medication provides pain relief; however, these drugs have an elevated risk of dependency. Doctors may prescribe opioids to a worker who suffers a broken bone, severe burn, back injury, or other severe injury. Pain medications are also prescribed after surgical procedures to control pain as the patient is coming out of anesthesia. Pain medication may also be needed during recovery as the patient heals from invasive surgical procedures.
Common opioids used for the treatment of acute or chronic pain include:
Opioids are intended for the treatment of chronic or acute pain because they reduce the intensity of pain signals to the brain thereby providing relief from pain. However, widespread addiction to opioids has become a problem because the drugs have been over-prescribed in many cases.
Opioids Can Cause Many Problems for Injured Workers
A worker who becomes addicted to pain medication can experience a variety of problems, including unemployment and criminal charges if they attempt to obtain opioids by illegal means. Workers who are addicted to opioids may also experience social and emotional problems, including damaging their relationships with family and friends as they struggle with their addiction.
Finding a Solution to the Opioid Problem
Unfortunately, no one has discovered a solution to the problem. The Centers for Disease Control (CDC), the Food and Drug Administration (FDA), the pharmaceutical industry, and state legislatures have been working on ways to decrease the risk of opioid dependency among all individuals, including injured workers.
The FDA formulated an Opioid Action Plan to fight addiction to opioids. In May 2016, the FDA approved the first implant for the treatment of opioid dependence. The CDC issued new guidelines for opioid prescriptions in an attempt to limit the number of patients receiving long-term prescriptions for opioids. The guidelines may be helping to stem the number of injured workers who may become addicted to opioids.
According to a study commissioned by Mitchell Pharmacy Solutions, the CDC guidelines may be working to decrease the amount of opioids prescribed to workers’ comp patients. The study examined more than 800,000 workers’ comp claims during the past six years to track five measurements before and after the CDC guidelines were issued.
The CDC guidelines recommend that doctors should not prescribe opioids for more than seven days. Prior to the guidelines, the study found that over 30 percent of the first prescriptions for opioids were issued for more than seven days. That number dropped to 23 percent after the guidelines were issued, but also found a massive increase in the number of prescriptions for a three to seven-day supply.
In addition to the decrease in the supply of opioids provided with the first prescription, the Mitchell study also found other factors that indicated physicians might be complying with the CDC recommendations. After the CDC guidelines were published, 70 percent of the opioid prescriptions were written for a lower dose of medication. In addition, the number of prescriptions for opioids concurrently prescribed with benzodiazepines was cut in half after the CDC issued its guidelines.
While it appears that the CDC guidelines may be working, there is still much to be done about the opioid epidemic in America, including in relation to workers’ compensation claims.
What Is Maryland Doing to Combat the Opioid Epidemic?
Maryland has been a leader in many of the efforts to stem the opioid problem in the United States. Maryland was the first state to issue a state of emergency because of the opioid epidemic. Governor Larry Hogan issued the state of emergency on March 1, 2017, which allowed him to allocate $50 million to fight the epidemic. In 2016, over 2,700 fatal opioid overdoses were recorded in Maryland.
The funding is in addition to the state’s Heroin and Opioid Emergency Task Force, the 2017 Heroin and Opioid Prevention, Treatment, and Enforcement Initiative, and the 2017 Prescriber Limits Act. Even though these measures are not aimed solely at workers’ compensation cases, the measures will likely have an impact on the number of injured workers who are prescribed or become addicted to painkillers.
Some of the measures in place that may help decrease the number of workers who may become addicted to opioids include:
- Prescribers and pharmacists must research a patient’s prescription drug monitoring program (PDMP) data for the past four months before prescribing opioids or benzodiazepines, with limited exceptions.
- Medical providers must check the patient’s PDMP data every 90 days until treatment is ended, with limited exceptions.
- The guidelines require providers to prescribe the lowest effective dose to treat the pain.
- With very few exceptions, prescribers must use the lowest quantity needed for the expected duration of the pain that is severe enough to require an opioid.
Maryland continues to introduce and adopt new laws and procedures to combat the opioid epidemic. It is impossible to know the exact impact these steps may have on workers’ compensation cases throughout Maryland. However, it is important to remain vigilant in the fight against opioid addiction in relation to employee injuries and illnesses.
Maryland Workers’ Compensation Lawyers
The workers’ compensation attorneys of Pinder Plotkin LLC are deeply concerned about the opioid crisis as it relates to workers’ comp claims. As more cases are heard regarding the addiction to opioids caused by workplace injuries, the laws may evolve and change. We will continue to follow this subject closely as we advocate for our clients to receive all the workers’ comp benefits they deserve after being injured at work.