The National Safety Council (NSC) recently reported that 75% of US employers have been directly affected by the opioid epidemic. According to the NSC, the construction industry is one of the worst-affected sectors, with twice the national average number of employees with substance use disorders.
There are a couple of factors that make the construction industry more vulnerable to opioid addiction and abuse exposures. First and foremost, the physically-demanding nature of the work, with long hours of bending, stretching, lifting, crouching, climbing and countless other physically taxing activities, translates to a very high frequency industry rate of injury. Those injuries include ones that occur traumatically as well as those that are degenerative and develop over time – and a lot of them lead to chronic pain for which injured workers are then prescribed opioid medications.
Like many industries, the construction sector is experiencing a bit of a workforce demographic shift. Simply put, there’s a shortfall of new workers while the current construction workforce is ageing. That’s putting pressure on what’s an already high frequency rate of industry injury, explained Rick Keegan, president of construction at Travelers. Furthermore, it’s leading to an increased rate of injury among new construction workers.
“At Travelers, we have robust claims data that shows 43% of all construction work site injuries occur in the first year of employment. So, we’ve got this influx of new workers with this higher rate of injury, which is once again, adding stress on an already challenging issue,” he said. “On the back-end of that, we’ve also got data that shows construction workers are working longer, which in the event of injury, results in the challenge of workers who are more likely to have pre-existing conditions. After long careers in a physically-challenging industry, injured workers become more difficult to medically rehabilitate post-industry and they’re more prone to chronic pain, which also then leads to a likelihood of them being prescribed opioid medication.”
In an effort to address the opioid epidemic and provide more comprehensive pain management for injured workers, Travelers created an Early Severity Predictor model, which helps forecast which injured employees are at higher risk of developing chronic pain, a condition that is often treated with highly addictive opioids. This allows for interventions to occur before opioid misuse can take hold and to ensure that injured workers are on most appropriate care path.
The results of the model, when combined with the insurer’s comprehensive pharmacy management program, speak for themselves. Travelers recently announced it has seen an almost 40% reduction in opioid use among the injured construction workers it has helped since 2015.
“When an opioid is first prescribed, it provides some level of pain relief. Unless that dosage is increased over time, its level of pain relief effectiveness will reduce,” said Rich Ives (pictured), vice president of workers’ compensation claims at Travelers. “If you have a worker who might be in pain from activities like pushing, pulling and lifting – which you would see a lot in the construction industry, or any other heavy-labor job – when that worker wants to return to work post-injury, they’re often looking for something that will relieve their pain rather than treat the root cause of it. The opioid is simply masking their pain and not treating the root cause, and the fact that the dosage has to be increased over time creates this dependency issue.
“At Travelers, identifying effective treatment of chronic pain is at the heart of what we’ve been trying to do [with the Early Severity Predictor model and comprehensive pharmacy management program]. Our ability to be able to curb the opioid epidemic has been a very nice bi-product of that. Our focus is, and continues to be: how can we address the root cause of chronic pain so that injured workers avoid the harmful effect of becoming dependent upon a drug to provide some level of pain relief?”
The Early Severity Predictor model kicks into action when the injured worker is in the acute pain phase – either directly after the injury or after surgery when they’re in the period of recovery. The model looks for characteristics and variables identified by Travelers as increasing the likelihood that an individual might suffer from chronic pain. That red flag is then passed to Travelers’ claim professionals and nurses, who will work closely with the at-risk injured employees to develop an aggressive treatment regimen, which often includes physical therapy and other interventions to prevent acute pain from becoming chronic.
“We’re committed to using our deep domain expertise, and our industry-leading data and analytics, to help address the causes of chronic pain,” Ives added. “We’re finding new ways to curb prescription opioid abuse while getting injured workers the care they need to return to work as soon as is medically appropriate.”