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July-August 2021

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20 PalletCentral • July-August 2021 palletcentral.com OSHA By Adele L. Abrams, Esq., CMSP Medical Cannabis, Opioids & Workers' Compensation E veryone knows that the United States is experiencing an epidemic of opioid addiction and overdoses. Recent data reflect nearly 17,000 prescription opioid overdoses – 35 percent of the total 47,600 opioid ODs overall. What everyone doesn't know is that many of these opioid addictions and eventual prescription drug overdoses arise from initial use to treat workers' compensation injuries. The statistics are sobering: A worker who uses opioids for a single day has a 6 percent chance of still using the drug a year later; a worker who uses opioids for 7 days has a 13.5 percent chance of still being on them a year later, and someone who uses the prescription for over a month has a 30 percent chance of taking them for a year or more. This long- term use can lead, in turn, to increased perception of pain, increased risk of depression, and increased risk of suicide. Workers who are abruptly cut off from prescribed opiates are also more like to turn to "street drugs" to avoid withdrawal and to alleviate the continued perceived pain. This ultimately can lead them to opioids contaminated with fentanyl – responsible for so many deaths in the U.S. A study by the Workers Compensation Research Institute (WCRI) found decreases in the frequency and amount of opioids dispensed to injured workers in recent years, a welcomed trend, but some states experienced higher utilizations of opioids and other high-risk utilization patterns. The states experiencing an increase in dispensing of opioids through workers' compensation were Indiana and Wisconsin (with Virginia, Louisiana and Iowa experiencing minor reductions). The biggest reductions were observed in Michigan, Maryland and New York – all states with legal medical cannabis (since this study was done, Michigan and New York also legalized recreational cannabis). WCRI also found that opioid use was prevalent among nonsurgical claims with more than 7 days of lost-time – up to 75 percent of these injured workers received at least one opioid prescription – and even higher in Arkansas (85%), Louisiana and Clearing the air on a complex issue for employers. iStockphoto.com/Ivan-balvan

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