Chronic Pain and Opioids in the Workplace

The opioid crisis impacts communities and workplaces across the country, and it’s crucial for employers to understand the connection between workplace chronic pain, on-the-job injuries and the dangers of opioid misuse.

Over 75% of U.S. drug overdose deaths involve opioids, taking more than 80,000 lives a year, according to the U.S. Centers for Disease Control and Prevention (CDC).¹ The risks of opioids in the workplace include opioid misuse and addiction, leading to increased costs, lost productivity and overdose deaths.

Employers and insurers have a responsibility to make opioid misuse prevention a priority, and early intervention plays an important role. Addressing chronic pain through timely medical care, non-opioid treatment options and coordinated return-to-work strategies can help support recovery and reduce the risk of opioid dependency in the workforce.

Why chronic pain is a risk factor at work

While acute pain from an injury typically lasts no more than three to six months, some employees experience lingering pain that becomes chronic.² Studies show that workplace injuries can lead to chronic pain at work, and injured workers may receive opioid prescriptions to help manage that pain.³  If left untreated, chronic pain in the workplace can contribute to a range of workplace issues, including:

• Absenteeism – Chronic pain is a common factor in absenteeism, and employees with musculoskeletal pain miss over 10 days of work per year on average due to the pain and related issues.⁴
• Reduced productivity and presenteeism – About 80% of employees say chronic pain leads to a decrease in focus and productivity at work.⁵
• Mental health issues – Experiencing chronic pain causes physical and emotional stress, increases the level of stress hormones in the body, and is linked to mental health issues including anxiety and depression.⁶
• Increased long-term injury risk – Workers with chronic pain have an increased risk of acute workplace injuries and ergonomic injuries such as sprains and strains.⁷

Chronic pain and employment are a costly combination, setting employers back $635 billion a year.⁸ Given the enormous human and business costs of chronic pain, it’s important to leverage employee wellness programs and alternative treatments to help employees manage pain with less risk of dependency on opioids.

How workplace injuries lead to opioid exposure

Workplace injuries can result in acute or chronic pain, and opioids are commonly prescribed for pain management. While the number of opioid prescriptions in workers compensation claims has declined over the past decade, about 1 in 3 workers compensation claims with prescriptions (32%) include opioids.⁹

Prescription opioids carry risks, including addiction, opioid misuse and increases in lost time from work. One study of workplace back injuries showed that in workers compensation cases with opioid prescriptions, short-term disability lasted three times longer than in cases with no opioids prescribed.¹⁰

Certain high-risk sectors such as construction, manufacturing and mining have higher rates of opioids prescribed for pain management in workers comp injury claims.¹¹ Opioids in the workplace are prevalent, with 75% of employers stating that this issue affects their company.¹² Travelers offers workplace injury and recovery resources to help employers proactively manage recovery and risks related to workplace injuries.

Opioid misuse in workers compensation claims

Despite an overall decline in prescriptions, opioids may still play a role in pain management for workers compensation claims, and even a single opioid prescription may impact the outcome. For example, workers compensation claims involving a prescription for opioids tend to be linked to longer recovery times and higher workers comp costs.¹³ And the risk of chronic work loss increases for patients who take opioids for longer than 90 days.¹⁴

One particularly challenging issue is chronic regional pain syndrome (CRPS), a long-lasting type of chronic pain that can occur after a workplace injury. CRPS workers compensation claims may involve opioid prescription, which can lead to long-term use, misuse or addiction.

Opioid prescriptions are more common in construction and other industries. Across all industries, employers play an important role in opioid misuse prevention.

Prevent opioid misuse through early intervention

Early intervention is crucial for preventing opioid misuse related to workplace injuries. Travelers uses the Early Severity Predictor^®, a tool that utilizes claim data to predict which injured employees are most at risk for chronic pain, allowing for early intervention and the engagement of resources. To help prevent opioid misuse through early intervention, employers can also implement early injury reporting, integrated medical care and proactive treatment plans. A robust workplace injury prevention program as part of an overall safety culture can help to avoid injuries that could lead to opioid prescriptions. And for employees who have been injured, alternative treatments can help with managing chronic pain at work.

What employers can do

Employers play a central role in opioid prevention in the workplace. Key actions employers can take include:

• Improve education and training – Educate employees on the risks of opioid misuse and the benefits of alternatives for pain management. Research shows that employee awareness training can help reduce opioid dependence and deaths.¹⁵
• Support injured employees – Support injured employees as they recover to help them safely manage chronic pain, deal with physical and emotional stress and prevent or get help for opioid addiction.¹⁶
• Implement ergonomic programs – Start with an ergonomic assessment and improve the task to reduce the risk of unsafe movement, which can make chronic pain worse or lead to another injury.¹⁷
• Monitor prescriptions – Work with your health insurer and pharmacy benefits manager to monitor aggregate data on opioid prescriptions to inform your efforts to limit overprescribing and offer alternatives for managing chronic pain at work.¹⁸

A supportive culture focused on employee wellness also may help employees avoid opioid misuse or addiction. Travelers safety and Risk Control resources can help employers implement these key actions in the workplace.

Help employees recover safely and sustainably

During employee recovery from a workplace injury, it’s important to balance safety, wellbeing and productivity. Employers can facilitate a sustainable recovery process by employing strategies like return-to-work programs, modified duty, employee assistance and recovery support.

An injured employee may be able to return to work sooner with light or modified duty, reducing the time lost from work. These strategies can help to reduce costs and improve productivity after a workplace injury.¹⁹

Learn more about workers comp and injury recovery

Employers navigating the opioid crisis in the workplace can count on Travelers as a trusted partner for injury prevention strategies, workplace injury and recovery resources, employee wellness support and workers compensation solutions. Risk managers and employers can connect with their Travelers representative for guidance in creating strategies to reduce opioid risks and improve employee recovery.

Sources
¹ https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html
^2,6 https://mhanational.org/resources/chronic-pain-and-mental-health
³  https://pmc.ncbi.nlm.nih.gov/articles/PMC8011586/
^4,5 https://www.hingehealth.com/resources/articles/excessive-absenteeism-and-chronic-pain/
^7,8 https://dorncompanies.com/national-safety-month-2021-week-3-how-chronic-pain-affects-worker-safety/
^9,10,11 https://www.cdc.gov/niosh/substance-use/opioids-and-work/workers-comp.html
¹² https://www.cdc.gov/niosh/substance-use/opioids-and-work/index.html
^13,16,18 https://www.workerscompensation.com/daily-headlines/the-ongoing-opioid-crisis-impacts-on-the-workers-compensation-industry/
¹⁴ https://www.enlyte.com/insights/podcast/pharmacy-benefit-management/why-opioid-trends-are-changing-workers-comp
¹⁵ https://link.springer.com/article/10.1007/s42461-021-00515-7
¹⁷ https://riskandinsurance.com/understanding-chronic-pain-in-the-workplace-how-employers-can-better-promote-employee-wellbeing/
¹⁹ https://www.reemployability.com/return-to-work-helps-reduce-workers-compensation-costs/