Dr. Jacob Lazarovic, senior vice president and chief medical officer, Broadspire, discusses opioid misuse and ways employers can mitigate their related workers compensation costs.
Drug overdoses have surpassed car crashes as the leading cause of preventable death for American adults, with prescription opioids contributing to more deaths than heroin and cocaine combined.
Opioid use has steadily risen for more than 20 years, peaking in 2013, with some moderation in the last few years. Although opioids are generally intended for short-term use for acute pain, 4 to 17 percent of users are on long-term opioid management. Average daily opioid dosages (MEDs) have more than doubled in the last decade. Opioid prescription volumes correlate closely with opioid overdose deaths, which hit 18,983 in 2014.
I could give you one statistic after the next, confirming the fact that opioid use is out of control, but rather, I want you to take away this: Pain is something we grapple with in the management of workers compensational claims and in an effort to reduce pain, opioids are overprescribed and have significant risks for dependency, addiction, and adverse effects.
Yesterday, I co-presented “Intensive Opioid Monitoring and Management: An Early Intervention Model” during the 2016 Risk Management Society (RIMS) Annual Conference & Exhibition at the San Diego Convention Center. My co-presenter—William Pezzutti, vice president of Corporate Risk Management, Adecco Group—and I provided the latest statistical information on opioids along with employers’ concerns, evidence-based guidelines for pain and opioid management, and related programs offered by Adecco and Broadspire.
Comprehensive Assessment and Management of Pain (CAMP) Program
Broadspire helps employers address the opioid epidemic by offering programs that improve quality of patient care and reduce costs. We have an array of pain-focused initiatives that fall under our CAMP umbrella. CAMP is an evidence-based, integrated and systematic approach designed to identify and address the biopsychosocial needs of individuals in pain.
Our expert clinical staff of board-certified physicians and nurses review these cases, evaluate the biopsychosocial influences of the problem and create, in cooperation with the treating physician, a treatment plan for each individual.
Designed to maximize injured employees’ comfort, functionality, quality of life and return to work, CAMP program steps include:
- early identification of patients who are at high risk for chronic pain and/or opioid misuse,
- streaming patients into the most appropriate medical management resources meeting the patient’s needs, and
- monitoring progress to resolution.
By applying our depth of clinical expertise—which includes medication reviews, case management, physician (peer) reviews, urine drug monitoring, cognitive behavior therapy, detoxification, and functional restoration—we develop value-added programs with measurable outcomes that are customized for each employee.
Broadspire Introduces First Opioid Fill Program
Within our CAMP program is the recently implemented early-intervention program called First Opioid Fill (FOF), which has several benefits that include:
- improved health and safety of our claimants by promotion of evidence-based best clinical practices,
- reduction of opioid prescriptions, dosages, and costs,
- earlier return-to-work and claim resolution.
FOF begins when the first opioid is prescribed and dispensed. Our pharmacy benefit managers notify us immediately, and our CAMP coordinator springs into action by informing the prescribing physician that we are monitoring care. In addition, we provide the physician with comprehensive opioid-related educational information and patient management tools. An information sheet is also sent to the patients, advising them to be cautious in their use of opioids, and that a timely reduction or elimination of these drugs is in their best interest.
The doctor is required to submit supporting information if an opioid prescription is renewed and prolonged. At the same time, additional levels of clinical review may be engaged, including RN case management and peer-to-peer teleconferences.
The FOF program was initiated as a randomized controlled trial so that definitive data would be generated for outcomes analysis. Initial results have demonstrated statistically significant benefits—20 to 50 percent reductions in opioid prescription volumes, total pharmacy spend, opioid spend, daily opioid dosage, and duration of opioid use.
By collaborating with managed care organizations, employers can successfully address opioid misuse and favorably reduce its impact in workers compensation.
For more information about Broadspire’s CAMP and FOF programs, please e-mail firstname.lastname@example.org.