Safety and OSHA News

Chronic opioid use: How it starts and ends, and what employers can do

How long does it take for chronic opioid users to wean completely off the drugs after a workplace injury? 

A new study by the Workers’ Compensation Insurance Rating Bureau (WCIRB) says workers in its research weaned off opioids completely within a median of 19 months after their injury. The median actual weaning-off period, start-to-finish, was eight months.

Injured workers who didn’t wean off completely during the study period still reduced their opioid dosage by an average of 52%.

Chronic opioid usage builds gradually. Injured workers in the study reached a prescribed opioid level of 50 Morphine Milligram Equivalents or greater per day in a median of 11 months from the date of injury.

The study found no clear patterns of successful non-drug treatments for weaning off opioids. In general, the weaning process involved a gradual decrease in opioid prescribing combined with a mix of alternative non-drug treatments and non-narcotic drugs.

The study looked at the cases of 1,030 workers.

Employers’ role

About 22% of injury claims studied in 2013 and 2014 with at least one paid medical service had an opioid prescription.

That’s slightly more than one in five employee claims.

What can employers do to reduce opioid usage among their employees?

  • Limit the quantity of pills on initial opioid prescriptions
  • Limit coverage of opioids to a network of pharmacies and providers
  • Expand coverage of alternatives for pain management, such as physical therapy, even if these options are more expensive
  • Monitor workers’ comp claims to determine whether opioid prescriptions are being used as a “low-cost option”
  • Reconsider zero-tolerance drug policies – unemployment can launch a downward spiral that can lead to accidental overdose; use job-reassignment instead where necessary for safety-sensitive jobs
  • Provide training to employees to increase awareness about opioid use
  • Create an environment in which employees can discuss their opioid usage with their managers (i.e. ensure employees they won’t face retribution for reporting prescribed opioid use), and
  • Revisit and enhance your drug counseling programs.
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