America is currently in the midst of the worst heroin epidemic in the nation’s history. The most common starting point for heroin addiction isn’t the drug itself, but rather its legal cousin: opioid prescriptions. They are both derived from the same source, and have similar effects. So, when the prescription runs out, many turn to other sources to keep their high. And because opioids have been overprescribed in the past decade or so, it has led to an increase in heroin use.
In 2015 alone, over $1.5 billion was spent on opioids for workers’ compensation claims — over 10 percent of all opioid spending. Workplace injuries has become one of the top reasons opioids are prescribed, fueling America’s addiction. So, some of the main players in the workers’ compensation insurance industry are making changes to reduce the prescription of those kinds of drugs.
One of the biggest changes is using predictive algorithms and behavioral health screenings to test whether patients are at a high risk for dependency. If they are, that patient is steered away from opioids and instead toward over-the-counter medicines and mental health counseling. In addition, if opioids are prescribed, both the doctor and the patient are sent packets of information about the drug, and refills are tracked. After 10 weeks, claims are reevaluated to check if the patient is still taking the opioids. If they are, the insurance company works with the doctor to make a plan for weaning the patient off the opioids.
When this program was tested, opioid prescriptions fell by about 14 percent. And that’s the goal of these changes. They want to catch risky patients and address the situation before it becomes a problem. In addition, when fewer opioids are prescribed, the price of claims falls sharply — one company reported a 50 percent reduction in individual claims costs.