Monday, June 24, 2013

Drug Abuse Hikes Workers’ Comp. Risks

Many players in the workers’ comp system are failing to comply with guidelines that recommend periodic drug screening and psychological treatment.
David M. Katz

CFOs worried about mounting workers’ compensation costs at their companies should look closely at how freely — and chronically — doctors are prescribing narcotics to injured workers in states where the companies operate.

The differences among states can be striking. At the top end, one in six injured workers in Louisiana and one in seven in New York were identified as “longer-term users of narcotics” on workers’ comp. claims made between 2009 and 2011, according to a 2012 study sponsored by the Workers’ Compensation Research Institute (WCRI).

In sharp contrast, fewer than one in 20 workers prescribed narcotics were identified as longer-term users in Arizona, Wisconsin, New Jersey, Indiana and Iowa, according to the study, which is based on data culled from nearly 300,000 nonsurgical workers’ comp claims involving more than seven days of work time. More than 1.1 million prescriptions for pain medications (including narcotic and non-narcotic drugs) were associated with the claims, which were made in 21 states.  
“If you are in one of those states [with the highest long-term narcotics use by injured workers], you will probably want to look into it and see how the problem can be addressed,” Dongchun Wang, a WCRI economist and co-author of the study, said during a recent webinar on the findings.
But regardless of the state where a company's operations are headquartered, the corporation runs the risk that its medical costs will rise over time because doctors may be over-prescribing narcotics to employees injured on the job. That's because many workers' comp health-care providers haven't been following recommended treatment protocols. Few injured workers who have used the drugs for years have been screened and tested for them or received psychological treatment for possible drug abuse, according to Wang.

The problem may stem from a bevy of “pain management” statutes and rules passed in a number of states in the 1990s, according to Dean Hashimoto, a doctor in the Partners HealthCare System and a member of the Massachusetts Department of Industrial Accidents Health Care Services Board. Fueled by the consequent growth of pain-specialty programs, practitioners began treating chronic pain “primarily through opioids,” he said during the webcast.

More recently, however, the abuse of painkillers has gotten a great deal of media attention. The issue of controlling the use of prescription narcotics gained currency on April 16, when the U.S. Food and Drug Administration approved updated labeling for a time-release reformulation of OxyContin tablets, a powerful and much-abused narcotic pain killer. At the same time, the agency barred an earlier, fast-acting version of the drug that could be crushed for illicit inhaling and injection.

The FDA also said that it would not approve any generic version of the drug “that [relies] upon the approval of original OxyContin.” That move brought objections from pharmacy benefits managers and claims handlers, who contend that banning generics would merely raise costs for employers without addressing a more fundamental problem: excessive prescription by doctors of such narcotics.
Although the WCRI study did not address OxyContin specifically, it addressed a broader issue: Many players in the workers’ comp system are failing to comply with “medical treatment guidelines for chronic opioid management” that recommend periodic drug screening and psychological evaluation and treatment.

Indeed, the institute’s research suggests that the biggest potential for abuse and the highest potential costs stem from long-term use by the injured. In response to a question during the webinar, Wang estimated that over the first year or two of a claim, prescription may represent just 2 percent to 3 percent of all workers’ comp costs.   
But for claims stretching out six or eight years, for instance, “prescription drugs represent 15 percent to 20 percent of all costs,” she said, adding that she had not researched the percentages of opioid use in particular.

Nevertheless, “longer term use of opioids may lead to additional costs, loss of productivity [and] put people at higher risk of opioid misuse and abuse,” she said, as well as accidental death. (The study treats “opioids” and “narcotics” as synonyms, defining the words as synthetic and non-synthetic drugs that act through specific receptors in the nervous system.)

Under protocols in Colorado, a number of actions should accompany any prescription of an opioid, according to Kathryn Mueller, medical director of the Colorado Division of Workers’ Compensation, and a co-author of the study. Nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen, or aspirin, for example) should be considered before narcotics are prescribed. But if opioids are prescribed, their use should be limited to three to 10 days.

The worker should return to work as soon as possible, with no bed rest but within appropriate restrictions on such activities as lifting and time spent sitting, Mueller said. There should be no MRIs or CAT scans unless there are neurological symptoms or if the worker is elderly. Finally, the worker should be provided with “education and reassurance,” she said. “The focus is not eliminating pain but managing pain to restore physical and mental function and quality of life.”

Monday, June 17, 2013

Background Screening Cautions Employers Against Making Three Most Common Drug Testing Mistakes

Jacksonville Beach, FL (PRWEB) June 14, 2013
“The National Institute of Health estimates that drug and alcohol abuse costs the economy over $300 billion a year. The impact on the workforce in terms of increased accidents, medical costs, turnover and loss of credibility in the marketplace are enormous,” noted Don Dymer, president and chief executive office of SingleSource Services background screening company. Dymer discussed the impact on the workforce with colleagues during a recent SilkRoad conference in Hollywood, Florida.
Dymer explains, “The object of the recruitment process is to identify and hire the best qualified for the tasks of the job, but an even greater emphasis must be taken to ensure that the many dangerous characteristics an employee may bring to the workplace are identified and excluded. Here are some sobering facts from the U.S. Department of Labor in 2010:
●75% of all illegal drug users are employed (full or part time) and
●3% says they have used illegal drugs before or during work
●79% of heavy alcohol abusers are employed
●7% says they have consumed alcohol during the workday.
As a business owner or manager reading these statistics, this means that there are hundreds of thousands of workdays missed, many injuries that could have been avoided, and many additional workers compensation claims that could have been avoided. What can you do to protect yourself from an employee who engages in substance abuse or commits a crime after they are on your payroll?”
Pre-employment drug screening should be just the beginning. A comprehensive program should include provisions for post accident, with cause, and random drug screening. Post drug testing by employers is legal in most states and may be administered to an employee without having first observed erratic or questionable behavior. This on-site, random drug testing can be an effective tool for employers as a deterrent to preventing problems attached to illegal drug use.
“Drug testing as part of a pre-employment/volunteer screening process is serious business and is one of the biggest areas where employers make mistakes. Some of the most common mistakes we see include: 1.) Failure to have a written drug policy in place that outlines what type of testing will be required and including a policy that outlines the possible outcomes that may result of a verified positive drug test result. 2.) Employees who have not been properly trained and certified to perform testing 3.) Jeopardizing the confidentiality of the test taker, again by not having firm policies or the proper training in place.” explains Dymer.
“Each of these mistakes places the employer at double risk. The risk of civil damages could be in the hundreds of thousands or more, add to that state and federal fines, and a poorly executed drug testing program could cost you millions," concludes Dymer.
Regardless of how large or small your business or organization may be, drug testing coupled with a complete background screening program should be treated seriously. Don't assume you can do it yourself, or that you are exempt from litigation simply because you were ignorant of the law. An experienced background screening professional is your best defense and safeguards your business and your reputation," states Dymer.
SingleSource Services is a national employment screening company. The company provides screening services to more than 2,300 companies and non-profit organizations. If you are interested in learning more about drug testing, or would like to purchase on-site drug testing kits, please visit the company at


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Wednesday, June 12, 2013

Phili Crane Operator In Building Collapse Had Pot, Painkiller In His System

PHILADELPHIA (CBS) — Sources tell CBS 3 the excavator operator involved with Wednesday’s deadly building collapse in Center City will face six counts of involuntary manslaughter.
Sources tell CBS 3 that blood tests on the excavator operator, 42-year-old Sean Benschop, detected the presence of a prescription painkiller and marijuana.
The blood, along with urine, was taken from Benschop at the hospital approximately two hours after the collapse at 22nd and Market Streets, which killed six people and injured 13. (See Related Story)
Sources say investigators also noticed that Benschop, who has a history of 11 prior arrests, including a conviction for possession and dealing drugs, was speaking in what police considered an unusually slow, quiet way, “almost whispering,” according to a source.
Crane operator Sean Benschop.
Crane operator Sean Benschop.

Benschop also allegedly told investigators, according to a source, that he was in pain and taking pain medication after recently cutting his finger.
The crane operator, who CBS 3 was not able to contact for comment, is not charged with any wrongdoing in connection with the collapse.
Late Friday afternoon, a search warrant was executed on Benschop’s home.  Police took two computers and another box of unknown items.
CBS 3 reported Thursday that two top homicide prosecutors from the Philadelphia District Attorney’s Office were at the collapse scene conferring with investigators, along with crime scene specialists.
A source confirms a criminal investigation may be launched soon. However, a spokesperson for the District Attorney’s Office replied Thursday that it is “too early” to speculate about any possible investigation.