OSEA Safety Blog

Narcotic painkillers in the workplace

Tuesday, July 22, 2014 John P. Coniglio - PhD, CSP, CHMM, RPIH, CSC

Reviewing cases involving industrial accidents presents many interesting facts about the workplaces we toil within, both construction & industrial. This information is gathered to a large degree from transcripts of testimonies from the injured and of interest is after the incident’ outcomes as it pertains to the treatment (medical) and the waiting disruption of the lives of injured workers.

I have always been amazed at the amount of narcotic pain medicine prescribed (loratab a favorite) to individuals with a past history of drug abuse. In several cases the worker sought out further treatment for addiction after on-going receipt of narcotic pain ‘killers’.

It made me wonder why these physicians are prescribing these narcotics and what are the alternatives?

The National Safety in its July 2014 edition of 'Safety & Health’ magazine reported on a study of prescription painkillers; “worker use of prescription painkillers; wide-spread, varies by state report”, authored by the Workers Compensation Research Institute released May 14, 2014. Upon review of 264,000 workers compensation cases and this 1.5 million Rx associated with them demonstrated some startling facts.

  • On average 85% of injured workers in most states (25 states included in study), received narcotic painkillers.
  • Typically the workers received 1800 milligrams of morphine equivalent narcotics per claim.
  • Workers in N.Y and Louisiana received 3600 milligrams on average. This is equivalent to taking a 5 milligram Vicodan tablet ever 4 hours for 4 months.

You further have to ask yourself how much of these narcotics go beyond the injured worker to others for illicit use? We all know the problems occurring with Rx drugs getting into the hands of recreational drug abusers! These drugs are leaving Rx by physicians working under U.S. authorization and certainly their aim is pain reduction after an accident. But it seems clear that the physicians and the U.S. Systems of States must begin to reconsider this approach and seek improved treatment and alternative pain reduction treatment.

Perhaps faster diagnosis and treatments authorized by the W.C. Systems would shorten the pain cycle experienced and get the resolution of the problem faster. Certainly, prevention of the accident in the first place would resolve the problem. Treatment modalities using narcotics as a last resort, not first reaction, would seem in order. Long term chronic cases should be sent to pain clinics for alternative treatment options. Any worker taking narcotic pain relievers would be suspect for return to work while taking the medication. Close review of a patients history of past drug abuse would certainly give pause to prescribing narcotics.
This is a serious situation requiring study and response...

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