The U.S. remains the biggest global consumer of prescription drugs, up from around 76 million in 1991 to nearly 207 million in 2013 however a recent court ruling has called into direct question the prescription practices of physicians nationwide (Volkow).

The occurrence of unnecessary or medically inappropriate prescribing of opioids in pain management is compromising the lives and well-being of injured workers.  There are a number of serious issues concerning the use of opioids in pain management:

  • Not cost effective
    Evidence-based reviews are seldom consulted prior to the prescribing of opioids, and a lack of appropriate physician monitoring and/or patient compliance further contributes to longer recovery periods and increased cost.
  • Increased drug-drug interactions
    Polypharmacy, the use of 4 or more medications simultaneously with opioids, can result in drug-drug interactions with severe consequences for patient health.
  • Risk for Addiction and Abuse
    The highly addictive nature of opioids leads to the necessity of higher doses over time, resulting in cost increase and greater risk of overdose/addiction. .
  • Lack of evidence for proven benefit
    Recovery and return to work rates are not improved by the use of opioids in pain treatment. The American Academy of Neurology and a number of states have released product guidelines advising physicians to proceed with caution when initiating opioid therapy for pain or long-term use.
  • Dose dependent risks for serious harm
    Physicians and patients are not always properly educated on use and good faith prescription practices and guidelines, including risks of remaining on disability, addiction, drug-drug interactions, and dosages at which death and risk of overdose dramatically increase.

Where do we go from here?
It’s never been more obvious than now that effective pain treatment must focus on the legitimacy and efficacy of treatments, keeping in mind the quality of care and quality of life of injured workers.  At ANS Solutions our pharmacotherapy review program is focused on protecting the injured worker by:

  • Better addressing the needs of pain patients with the assessment of treatment programs and help of evidence based reviews.
  • Improving recovery times with the proper monitoring and modifications of treatment.
  • Reducing the risks associated with common opioid treatment regimens by consolidating and coordinating drug therapies between multiple prescribers, identifying duplicate therapies and excessive dosages, and pointing out alternate medication regimens.

Positive change stems from a comprehensive and economically responsible approach in the treatment of pain in workers compensation cost containment claims settlements. To learn more about pharmacotherapy review contact ANS today.


Volkow, Nora D. Prescription Opioid and Heroin Abuse, House Committee on Energy and Commerce Subcommittee on Oversight and Investigations.;  April 29, 2014.