Those in the Workers’ Compensation industry are overly familiar with the war on opioids. The topic is covered by speakers at almost every conference and rightly so. In Results’ home state of Tennessee there are more prescriptions for opioids written annually than there are residents, 1.18 scripts for every person! According to the CDC there were 1269 deaths related to opioid overdose in the state of Tennessee alone in 2014, 47,055 in the entire United States. What is sad is these numbers actually demonstrated an improvement over 2013. Obviously this nation has an epidemic on their hands that needs a sophisticated solution.
The Workers’ Compensation industry has made strides to improve the the utilization of opioids. Strengthening the utilization of prescription drug monitoring programs, implementation of treatment guidelines and use of drug formularies have contributed to early successes. A WCRI study of 25 states demonstrated a significant reduction in opioid reduction between 2013 and 2014, with statistically significant reductions(greater than 20%) in six of the states. The overall number of prescriptions per injured worker fell from 3.33 to 2.91. While this is great progress there is still work to be done.
Besides the obvious safety risks the use of opioids adds significant cost to the Workers’ Compensation system. In Express Scripts’ Tenth Annual Workers Compensation Annual Drug Trend Report, it was revealed that opioids are the costliest class of medication in occupational injuries at $450.90 per year per user. And while overall medication usage in Workers’ Compensation cases was down 2.6% in 2015, total pharmacy spend increased 2.2% due to the increased cost of drug prices in the United States. With drug prices consistently on the rise, there will need to continue to be a significant decrease in utilization to decrease costs or even just to remain status quo.
So besides regulation and education; what can be done to protect the safety of our injured workers while decreasing the cost of spend on these potentially harmful drugs?
The CDC has stated in their updated guidelines that Physical Therapy is not only safer but is more effective in the treatment of chronic pain than opioids such as Vicodin and Oxycontin. Not only does Physical Therapy help treat the symptoms of chronic pain, Physical Therapists are experts in orthopedic evaluation and finding the root cause of the patient’s dysfunction and chronic pain. Physical Therapists trained in Manual Physical Therapy have been demonstrated to be the most effective in treating orthopedic conditions. Manual Physical Therapy not only increases joint mobility and range of motion through specific manual techniques; but also helps maintain these gains through specific exercises that facilitate proper movement patterns. Manual Therapy also has neurophysiological, biochemical and psychological effects that help reduce a patient’s pain safely and naturally.
As we become more educated on the danger and cost of opioid use, other solutions most be offered to our injured workers to help control their painful conditions. We must get our injured workers into the hands of the most highly trained Manual Physical Therapists to not only ease their symptoms but also find the solutions that will get them back to work as quickly and safely as possible.
