Pain management is a difficult and potentially controversial area in workers’ compensation in Massachusetts and elsewhere because it is believed that long-term use of opioids can delay returning to work and increase the cost of a claim. On the other hand, some work injuries are so severe, and cause such incredible pain, that many workers feel they have no choice but to take opioids. If you have been severely injured, you should be aware of some recent studies regarding opioid use and pain management.
Recently, the Workers Compensation Research Institute (WCRI) released new findings that almost 80% of injured workers around the U.S. received at least a single opioid prescription and many received prescriptions over a period of 6-12 months after the initial injury.
For the WRCI study, Long-Term Use of Opiods, opioid use was studied in close to 300,000 workers’ compensation claims and 1.1 million associated prescriptions in these states from 2006-2009 (last prescriptions filled in 2011): Arkansas, Arizona, California, Connecticut, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin.
The prevalence of long-term opioid use in most of these states increased or stayed the same over the period of the study. In Massachusetts, however, the state had adopted new treatment guidelines to deal with chronic pain. Possibly in connection with these new guidelines, long-term opioid use decreased by 4% over two years.
Arizona and Wisconsin had an even lower percentage of long-term users. In contrast, there were several states in which about 10% of workers who had been injured on the job took opioids over the long haul.
Some of the suggestions for combatting longer-term misuse of opioids is random drug testing. Also recommended are periodic psychological treatment or evaluation to help address the addictive potential of opioids.
If you have been seriously injured in a work-related accident and are experiencing chronic pain, you may be wondering what’s wrong with taking opioids for a longer period. Experts say that there are two million people addicted to opioids in America. Prescription drug overdose is responsible for many deaths—drug overdose in general causes more deaths than car crashes do.
Outside of workers’ compensation, experts disagree about whether opioids are appropriate for chronic pain, but generally they, too, find that long term use of opioids is not a good idea. In some cases, opioid use over the long term can make pain worse. In many cases, addiction becomes a normal way of life. Treating addiction is very difficult. Simply stopping the opioids isn’t an effective response, because many patients turn to the black market.
Also, in a recent study (login required), many patients with chronic pain and longer-term opioid use (more than a decade) showed an increase in hormonal and inflammatory markers. This means that many longer-term users have inflammation not relieved by opioids. An underlying condition like fibromyalgia or lupus may be the cause.
In those cases, the symptoms are merely masked and the underlying condition is not treated. Tests also show about 85% of these patients have a genetic metabolic defect in opioid metabolism. Hormonal suppression was an issue in 20% of the patients, including deficiencies in cortisol and testosterone.
If you have been seriously injured on the job and are experiencing chronic pain, an experienced Massachusetts workers’ compensation attorney may be able to help. Contact us by calling 800-367-0871 or using our online contact form.