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IAIABC: Responding to Inappropriate Opioid Use Critical to Workers' Compensation

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Madison, WI (WorkersCompensation.com) - The IAIABC Executive Committee is very concerned about the inappropriate use of opioids in workers’ compensation and the adverse effects it can have on injured workers. The Executive Committee is extremely interested in providing resources that can help jurisdictions appropriately respond to this problem. The IAIABC will continue its efforts in this area and have plans to move forward with a resource paper that we believe will benefit all jurisdictions, regardless of their legislative or regulatory structures.

Opioid use and abuse is a complex and critical problem that is having a profound impact on workers’ compensation and in group health as well. The IAIABC has been discussing this growing epidemic for several years through its educational programming, in committee meetings, and through information and resources for its membership. Over the past year,  members of the IAIABC community worked on legislative and regulatory models with the intent of helping jurisdictions address this challenge. The Executive Committee commends the efforts of the Medical Committee and the many volunteers who contributed to the draft models. After thoughtful review by the Executive Committee, it was determined that adopting model legislation and regulation on opioid use could be interpreted as too narrow and restrictive for jurisdictions. The Executive Committee was concerned the models could  unintentionally create conflict in jurisdictions that may be already taking steps to initiate regulations for appropriate guidelines. However, they contain valuable information, and as such the Executive Committee is asking that the issues addressed in the drafts be re-framed to offer policy considerations rather than a single policy response.

In order to continue the efforts in dealing with the growing opioid problem, the IAIABC Executive Committee supports a refocused approach to address the issues that jurisdictions need to consider when crafting policy responses to this issue. There are multi-disciplinary issues to consider that cannot be adequately addressed in either model legislation or regulation. The Executive Committee feels that the analysis must consider the various positions taken by, and laws already in existence, among the diverse jurisdictional membership and provide a thorough presentation of the issues in opioid treatment regulation that the jurisdictions can and should address as they go forward with their respective legislative and regulatory processes.

The new document will provide background material on the opioid problem; analysis of exiting law and regulation in the various jurisdictions that have already dealt with the issues; and listing and general analysis of the issues that should be addressed in the legislative and regulatory process. It will also include examples of regulation and legislation, much of which will be pulled from the draft model language.

The Executive Committee looks forward to working with the IAIABC Medical Issues Committee in drafting this updated document that help jurisdictions address the opioid problems they face while respecting each jurisdiction’s individuality. The Executive Committee hopes to have an updated document prepared for presentation at The IAIABC Forum in April.

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Jan Dacre RN CCM 03/01/2013 01:36:38
Back in the early 80's we treated pain with comprehensive interdisciplinary programs. We did not focus on or emphasize pain. We placed those admitted on pain medication on a supervised medication reduction schedule. Pain medicine dependence was replaced with exercise and conditioning, dietary and or weight management, relaxation techniques, counseling and group therapy, with an emphasis on return work.

In the mid 80' s the pain management and accreditation bodies changed focus and forced persons to focus on pain even if you had no pain. You could not have a healthcare encounter without be drillied about your pain perception, with medication being almost forced if you had discomfort.

At the time I knew the approach was flawed but felt criticized for voicing my concerns. Today, you can not pick up a magazine or newspaper without hearing the very sad consequences of pain medicine addictions. I put the blame on the healthcare system and the philosophy that you should not have any discomfort. The philosophy deserves an honest re-evaluation in my humble opinion.
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