Specialty Work Comp Network Expertise Plays Key Role in Combating Opioid use Disorders

What’s become clear from years of combating opioid use disorders is that, for most patients, recovery is difficult and often protracted. Just as important, we’ve learned that the greatest chance for success arises when the most accomplished health care professionals are empowered to deliver care that is well-coordinated, that incorporates multiple treatment methods, and that adopts a biopsychosocial perspective. By working together, health care professionals and their network partners are best suited to help injured workers recover from opioid use disorder and get back on the job.

The notion of attacking this problem from multiple sides isn’t unique. Public health officials are turning to this playbook to fight COVID-19. Health experts are imploring people around the world to wear face coverings, wash hands, maintain distance from others, avoid large gatherings, and to quarantine when ill or exposed. Alone, none of these efforts is as effective as the combination. Likewise, when treating an opioid use disorder, relying on a menu of options is far more likely to achieve success than is any single measure.

The urgency of this problem has become clear to employers, and there are several approaches that have aided in preventing opioid use disorder. These range from early intervention screening tools, risk-factor monitoring, best-practice prescribing guideline adherence, and careful patient selection and follow-up.

Beyond the obvious physiological gains of curbing misuse of opioids, there are broader treatment benefits in discontinuing the drug of abuse, remaining free of the drug, and being productive at work, at home, and with family and friends. To reach these important ends, it’s crucial that treatments consider the whole person. The various players orbiting an injured worker in treatment must act in concert to establish the most solid foothold that could lead to a successful outcome. Clinicians and prescribers, case managers, employers, and family and friends all have a role to play.

Perhaps most important of these measures is the idea that the diagnosis and treatment planning should be tailored for an individual and his or her support systems such as family and friends. From there, clinicians overseeing recovery treatment should be sure care remains coordinated. This means aligning efforts to address possible behavioral health conditions such as anxiety and depression.

These efforts aren’t easy nor are they always successful on the first try. By one estimate, nearly nine in 10 patients in treatment for opioid use disorder suffer relapse. Given this, it’s wise to provide additional support alternatives for those attempting recovery. These include mutual aid groups, peer-support specialists, and other relevant community services. Taken together, the breadth of these measures offers the fullest chance of helping an injured worker recover from opioid use disorder.

Given the inherent murkiness surrounding a patient’s response to treatment for opioid use disorder it’s critical to remain vigilant for the possibility of relapse. That’s why detoxification alone remains an insufficient and easy-to-topple treatment. A relapse-prevention program is essential. This can include a variety of measures including hypnosis, relaxation techniques, or acupuncture. Psychosocial treatments can help patients hone their coping skills, change their environment, engage in further counseling, and perhaps group therapy, 12-step, or other self-help programs. For these types of recovery support services to work, it’s important to put in place a plan for long-term follow-up. That’s the surest way to help reduce the likelihood of relapse. It’s also wise to measure and evaluate outcomes of treatments to help improve interventions and therefore increase patient safety. Whatever method a clinician leans on to help an injured worker, it’s important to engage in regular and frequent follow-up, careful monitoring, and support.

What’s most important when considering treatment of opioid use disorder is that its providers have relevant expertise, repeatable protocols, and a multidisciplinary team in place including an experienced intake coordinator and someone with expertise in behavioral health. Having this kind of bench strength makes it possible to assemble a complete and experienced recovery team. There is also value in seeking network partners armed with knowledge about both injured workers and addiction recovery such as with a specialized network within a broader network. A well-established network can feature complementary conduits specializing in opioid use disorder, behavioral health, diagnostics, and other relevant services.

A network that is well-suited to helping an injured worker suffering from an opioid use disorder is also likely to offer various treatment options for the injured worker including inpatient, outpatient and residential. This enables clinicians and others who are a part of the injured worker’s recovery team to customize the treatment plan.

Having a record of success in treating patients with opioid use disorder is essential. The same is true for the network itself. In order to identify those providers with the most to offer patients, it’s imperative that a network screen for clinicians with the proper training who have demonstrated skill at helping patients recover. A broad-based network can mine for these types of metrics around performance and efficacy in treatment of patients experiencing opioid use disorder. And, naturally, a broad network can select providers using a larger and more diverse base of data.

A network with sufficient depth can not only boost the number of providers who meet quality standards, it also can rely on more rigorous standards for inclusion within this opioid-recovery pool of clinicians. By having more providers to choose from, a network can be more selective about whom it includes within a specialty network, including those built around addiction and misuse or related areas of behavioral health. These providers can be further stratified to select those who have experience in treating injured workers and in treating patients with opioid use disorder.

Much work also falls to experienced case managers, who often have good working relationships with top providers, and recommend injured workers to treating providers. That strength in the clinical realm can be matched with strength in a network itself to offer the best-possible assistance to injured workers with an opioid use disorder. The network and clinical experience, together, can direct more power toward enabling recovery and promoting better case outcomes.

Treating injured workers who are also suffering from opioid use disorder comes down to expertise. That’s expertise in the network itself, in case management, and, of course, in providers with specific skills and experience in approaches to opioid usage. Aligning these efforts offers injured workers the best possible team for achieving recovery and returning to work.

By Kate Farley-Agee

Kate Farley-Agee has over 20 years’ experience in the health care industry and oversees Coventry's national provider network product development and state-certified networks across the country, as well as being a contributing author to Coventry’s Blog The Sounding Board.

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