There is an opioid epidemic in the United States. In fact there are over 42,000 opioid-related deaths in the United States each year, according to the Centers for Disease Control and Prevention (CDC)—a figure that has been rising steadily since the turn of the century. The opioid death rate is now more than five times greater than it was in 1999.

FACT:  Approximately 100 Americans die from a prescription opioid overdose daily, the Dept of Health and Human Services declared a public health emergency in October 2017.

When it comes to workers compensation claims, prescription opioids can greatly affect the length of the claim as well as the overall cost.  A recent John Hopkins study which can be found here says that “The opioid costs of the claimants whose prescriptions extended three months and more, compared to those prescribed opioids for less than 30 days, were significantly higher ($8,618 vs. $94), as were the average total cost per claim ($81,510 vs. $21,539).”  

Limiting the use of opioids in a workers compensation claim, when possible can great reduce the cost of a claim but ultimately lead to a better injured worker experience.



In the most basic terms, the CDC defines opioids as “a class of drugs used to reduce pain.” However, not all opioids are the same. There is a wide range of legal and illegal drugs that are classified as opioids. For example, Vicodin, a legal painkiller commonly prescribed to patients, is an opioid. By comparison, heroin, an illegally manufactured drug that has no medical use, is also an opioid. Both are killing thousands of people each year.

A common question people ask is if there is a difference between Opioids and Opiates.  These terms are used interchangeably by many who report on the opioid crisis. While this may be fine for a basic understanding, knowing the difference between opioids and opiates could matter to your organization.


  • Opiates – derived from the opium plant and includes opium and offshoots like codeine and morphine.
  • Opioids – Almost identical to opiates, but are made synthetically and not derived from the opium plant.  This term is broader and includes opiates, synthetic equivalents.  Common synthetic equivalents are fentanyl, hydrocodone, Methadone, and Percocet.



Unlike other drug epidemics, the reach of opioids is unique. This crisis affects all people in all economic classes, but in different ways. People who can afford prescription drugs are just as susceptible to an overdose as those who cannot afford them because of the unprecedented availability of cheap substitutes. This can make it extremely difficult to create a meaningful opioid strategy.

Pharmaceutical companies created opioids and aggressively pushed these medications to doctors during the 1990s. The market soon became flooded and the number of patients being prescribed opioids rose sharply. Over the years, prescription pill addictions transformed and many began using heroin and fentanyl. Now, our country must figure out how to contend with widespread availability, a saturated market, new synthetic drugs and an unrelenting overdose rate.


Most businesses whether small or large are unaware as to how much influence prescription drugs have on their claims costs. According to the research and consulting institue Altarum, the economic toll of the opioid crisis exceeded $1 trillion between 2001 and 2017.   One-third of that cost is typically shouldered by health insurers and workers’ compensation carriers.  This directly affects what your company will pay for workers compensation insurance.



According to NCCI “The Centers for Disease Control and Prevention says that in 2016, the US prescribing rate for opioids was 61 prescriptions per 100 persons. This issue is of particular concern to stakeholders in the nation’s workers compensation system, because injured workers are often prescribed opioids to ease pain from their injuries. NCCI data shows that injured workers who were prescribed at least one prescription in 2016 received three times as many opioid prescriptions as the US opioid prescribing rate. These figures illustrate that workers compensation is directly affected by the far-reaching societal impacts of the opioid epidemic in the United States.”

The opioid epidemic is becoming even more important in workers’ compensation settings since prolonged opioid use has been associated with poorer outcomes, longer periods of disability and higher medical costs for injured workers.



Many states either have implemented parameters on prescribing opioids or are in the process of doing so. For example, some states now limit the quantity of opioids dispensed for first-time prescriptions. Certain states are also proposing that opioids are kept off insurers’ preferred lists for pain medications.

Some workers’ compensation carriers and government agencies that have shouldered the cost of the opioid crisis want their money back. But any reimbursement is likely to require an investigation by Congress, lawsuits by individual states, counties and cities, collaboration among attorneys general and class-action lawsuits.



People experience pain differently.  Most people think a prescription may be best to offset the pain, but this isn’t always the best solution for managing pain.  Prescriptions can lead to misuse and addiction.

Here’s a few ideas:

  • Physical Therapy – Specialists can get to the primary cause of pain for treatment.
  • Meditation – A more holistic approach for managing pain is focusing on the mind and body.  Medication can lead to helping deal with the pain through a variety of mental exercises.
  • Acupuncture – This ancient practice can help control your body’s energy and treat pain and other conditions.
  • Exercise – Doing routine stretches and minor exercises such as walking can help manage chronic pain.
  • Hypnotherapy – Hypnosis can help with concentration and managing pain.



The opioid crisis is not going away any time soon. Estimates show this epidemic costs the U.S. economy over $95 billion annually, with employers paying $18 billion of that themselves. The unfortunate truth is that these figures are only expected to rise. Employers need to do everything possible to combat the impact opioids have in the workplace.

There is no silver bullet for this crisis. However, exploring new initiatives can help you develop your own strategy to best suit the needs of your employees.



Even if employees themselves are not using opioids, their lives may be affected by loved ones who are. This can indirectly affect their job performance and contribute to the overall crisis.

Employers should do their best to provide employees with educational materials to help them understand and take action against the opioid crisis. Lasting reform can only happen if individuals take charge of their situation.

Here’s a few thoughts that an employer could do to help employees.

  1. Post educational materials
  2. Explain the Risks of Opioids
  3. Encourage employees to speak with a physician
  4. Promote your companies Employee Assistance Plan.
  5. Encourage helpful communication.



Knowing what to look for can help your company spot employees with potential addiction problems.  The following list summarizes some common signs that employees may be abusing drugs.

  1. Constricted pupils
  2. Itchy Skin
  3. Needle Marks
  4. Mood swings
  5. Difficulty staying awake
  6. Scheduling multiple doctor visits in an effort to get more prescriptions

If you notice any of these signs it’s best to document and then talk to HR and let them handle any investigation.  Depending upon your company size there are a variety of legal considerations that can come into play that must be considered when dealing with drug abuse.

A few organizations that may affect how you can deal with these types of claims are:

  • Americans with Disabilities Act
  • Family and Medical Leave Act
  • State Laws
  • Federal Laws
  • Workers Compensation laws
  • OSHA Regulations


Employers must take an active role in curbing opioid abuse in the workplace. Companies that do not are risking lawsuits and a litany of HR headaches. By understanding the scope of the epidemic, acknowledging the risks your workforce faces and re-evaluating internal policies, your organization can more effectively manage employees struggling with opioid addiction.

DirectWorkComp LLC has resources if you have any questions about where to begin on your journey to a safe and productive work environment. Together we can help improve the health of your business, your employees and your bottom line.

If you would like a quote or to visit about how DirectWorkComp can help your business please reach out to us at 888-399-1190 or drop us a note at team@directworkcomp.com.


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