Across the country, the use of opioids accounted for 63% of the 52,000 drug overdoses in 2015.
Medications that fall into the opioid category include fentanyl, codeine, hydrocodone, morphine, and oxycodone, which are usually prescribed for acute or severe pain due to illness, surgery or accidents.
As physicians became more comfortable with prescribing them for a myriad of ailments involving “pain,” they failed to see the effect of their treatments until it was too late.
The American Society of Addictive Medicine says that of the 20 million Americans in 2015 who suffered a substance abuse issue, two million were attributed to prescription pain relievers and almost 600,000 involved the use of heroin.
|Workers' comp insurers impacted
Finding alternative treatments is a priority for physicians and workers' comp insurers, and there are a number of options available including acupuncture, exercise, non-opioid medications, massage therapy, physical therapy and cognitive behavioral therapy.
States are also passing legislation that limits initial opioid prescriptions to seven days, to reduce the incidence of addiction. Kevin Bingham and a team from Deloitte Consulting examine some of the other treatment options available to physicians that do not require the use of opioids in the August issue of Claims magazine.
|Related marijuana issue
A related issue involves the use of medical and recreational marijuana. Currently legalized in 29 states, that number is expected to increase over the next 12 months.
While the federal government still classifies marijuana as a Schedule 1 drug, meaning it is not currently accepted for medical use, it is possible that insurers are unknowingly receiving and paying invoices for it when they are bundled with other charges or buried within unclassified drug codes. Michelle Hibbert-Iacobacci provides an update on what to look for when reviewing invoices coded for medical marijuana and what questions to ask in order to determine what is actually being billed in her article, “Are insurers paying for marijuana?“
There are no easy fixes for either of these issues, and insurers must continue to watch what transpires at the state and federal levels to protect themselves and their policyholders.
On a more positive note, our Iconoclast columnist, Ken Brownlee, celebrates 50 years in the claims and risk management business this year. He has been sharing his insights and expertise with our readers for almost as long and we appreciate his willingness to educate generations of claims professionals through Claims and PropertyCasualty360.com. We look forward to his instruction for years to come.
Patricia L. Harman is the editor-in-chief of Claims magazine. She can be reached at [email protected]. Opinions expressed are the author's own.
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Patricia L. Harman
Patricia L. Harman is the editor-in-chief of Claims magazine, a contributing editor to PropertyCasualty360.com, and chairs the annual America's Claims Event (ACE), which focuses on providing claims professionals with cutting-edge education and networking opportunities. She covers auto, property & casualty, workers' compensation, fraud, risk and cybersecurity, and is a frequent speaker at insurance industry events. Contact her at [email protected]
