Claimants with injuries sustained from an auto accident or during their workday will often be prescribed pain medication in addition to medical equipment such as crutches or even a wheelchair in order to return them to their initial state of wellbeing. While many claimants follow the prescribed treatment regimens and their medical provider’s instructions, some of these prescribed drugs may lead to addiction or overdose.
Opioids in particular are a frequent cause of overdoses and are a growing concern for insurance carriers due to their potentially lethal nature. These drugs can interfere with the respiratory system and blood pressure, leading to possible death if a claimant does not properly adhere to the prescribed dosage. Increasingly, insurance carriers are experiencing rising claims costs due to opioid complications and claimant safety is a top priority that many carriers are at a loss to properly address.
The misuse of opioids is becoming more prevalent within the general public and measures are being taken to prevent opioid misuse and addiction. Legislators have begun implementing changes to law that allow law enforcement officers and other emergency medical personnel to carry and dispense Naloxone, which counteracts the depressant effects of opioids. Opioid overdoses are reversed within seconds of Naloxone being administered; however, this drug is not yet widely available for all emergency personnel across the country.
Some medical providers offer alternatives to claimants to relieve pain associated with their injuries before prescribing an opioid. Everyday Health suggests that over-the-counter analgesics and NSAIDs (nonsteroidal anti-inflammatory drugs) are possible substitutes in some cases. Medical providers are also attempting to relieve pain through the use of serotonin and norepinephrine inhibitors or through prescribing corticosteroids. In some instances, electrodes may be implanted within the body to help alleviate pain. Other claimants suffering from workplace injuries may experience relief of more chronic pain by implementing an exercise routine or seeking treatment from a physical therapist. To date, these alternatives have not been able to completely eliminate the need for prescription painkillers such as opioids.
Naloxone is somewhat limited and alternative pain relief methods may not be suitable for many auto no-fault or workers’ comp claimants, so it is vital for insurance carriers to monitor claimants utilizing opioid prescriptions. As a third-party benefit administrator for auto no-fault and workers’ comp claims, Northwood has proven systems in place to assist with daily tracking of these claims. Front-end authorization processes and thorough review of all prescribed medical treatments and drugs ensure that claimants are receiving the appropriate type and dosage of pain relievers. Northwood implements utilization management for insurance carriers as well, providing reports on claimant compliance with instructions from medical providers. These systems allow insurance carriers to proactively prevent misuse of opioids and assist in identifying the potential for claimant addiction or overdose. These procedures not only aid in reducing costs related to auto no-fault and workers’ comp claims involving opioids but perhaps most importantly they also offer a way for insurance carriers to provide the best outcome to indemnify claimants while reducing the risk of overdose and addiction.
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