Low back pain medication addiction is an all to pervasive and  entrenched problem nationwide. As a recent Wall Street Journal article highlighted, some of the most innovative approaches for fighting painkiller addiction are coming from the workers compensation industry.

Work injuries and conditions are among the primary reasons doctors prescribe opioids, and dependence has become an corollary issue for injured workers and their families. It is also a financial cost to workers compensation insurers and employers, costing $1.54 billion on opioids in 2015, or 13% of total U.S. spending on opioids, according to an analysis by CompPharma LLC.

Adjusting companies handling workers compensation claims are trying new programs that push workers toward alternative pain treatments and make it more difficult to get prescriptions for potentially addictive drugs–all intended to get people back to work without getting hooked.

Workers compensation insurers are using predictive algorithms and behavioral health screens to assess an individual’s risk for dependency, and steering some injured workers to alternate treatments such as over-the-counter drugs and mental-health counseling in lieu of prescription opioids. Such programs are aimed at preventing abuse, rather than treating it after the fact.

When an injured worker is first prescribed a drug like Fentanyl, Broadspire mails an opioid education packet to both patient and doctor, and tracks refills. Claims are reviewed after 10 weeks to check whether the patient is still taking opioids. Broadspire then works with the physician to make plans for weaning the patient off the drugs, he says. In a test of the program, opioid prescriptions fell by 14% compared with a control group.

Insurer Travelers Cos. has developed an algorithm that analyzes thousands of claims and identifies the likelihood that an injured employee will develop chronic pain. Certain conditions, such as a prior case history of anxiety or depression, increase the chance that a patient will experience chronic pain. Those deemed at risk for chronic pain and addiction receive recommendations for alternate therapies, such as physical therapy and counseling.

Travelers says it cannot prevent a physician from prescribing opioids for at-risk patients, but it does urge care providers to follow a plan for alternate therapies and can dispute an authorization for payment of painkiller prescription, depending on state workers compensation law.

Travelers says its algorithm, used in 20,000 cases in the past year, has helped reduce individual claim costs by as much as 50%. The predictive model and other efforts have helped reduce opioid prescriptions by 23% in the past 12 months among covered workers, according to the company. WSJ 11/15/16.

McCormick Law Office in Milwaukee, Wisconsin represents workers with low back pain and certainly encourages the exploration of pain medication alternatives for workers compensation clients.