Business group urges employers to get more involved on opioid use

Despite the fact that the CDC's guidelines were issued more than two years ago, overprescribing and prescriptions of opioids for acute pain management are still a problem.

Employers are being urged to actively get involved with their health plans and PBMs and ask directly whether those plans and PBMs are working with clinicians to implement strategies to mitigate risk of addiction. (Image: Shutterstock)

Employers are being urged by the National Business Group on Health, a non-profit association of more than 420 large U.S. employers, to step in and work with health plans and pharmacy benefits managers to make sure national guidelines on opioid prescriptions are being followed.

According to the group, despite the fact that those guidelines were issued more than two years ago, overprescribing and prescriptions of opioids for acute pain management are still a problem. Hence its action, as it calls “the misuse and abuse of opioids a national issue that profoundly impacts employees, their families and employers.”

Related: 3 proactive ways to address the opioid crisis in the workplace

Making sure that the “Guidelines for Opioids for Chronic Pain,” released by the Centers for Disease Control, are being followed is a matter for businesses as well as the CDC, according to the group. The guidelines, which provide recommendations for opioid prescriptions as well as the management of patients using them for chronic pain, provide recommendations for dosage, duration and follow up, in addition to recommendations on assessing risks and harms.

But in the ongoing epidemic of opioid use, it’s also clear that additional actions must be taken. “Inappropriate use and abuse of prescription opioids is rapidly becoming a major issue for employers across the country,” Brian Marcotte, president and CEO of the National Business Group on Health, said in a statement.

Marcotte added, “In addition to the devastation it causes employees and their families, research shows opioid misuse costs employers billions of dollars from absenteeism and presenteeism alone, affects hiring and retention, and negatively impacts worker productivity, workers’ compensation claims and overall medical costs. While health plans and PBMs have initiated various opioid management programs, opportunities remain to implement the CDC guidelines and we recommend employers work with their vendor partners to review the guidelines and take action to fill any gaps.”

In particular, the group says employers should get actively involved with their health plans and PBMs and ask directly whether those plans and PBMs are working with clinicians to implement strategies to mitigate risk of addiction before starting and periodically when continuing opioid therapy. In addition, they should ask whether limits on opioid prescriptions for acute pain are being set to short durations, with three days or less often being sufficient.

The group also says employers should be inquiring about using immediate-release opioids when starting therapy for chronic pain, instead of using extended release/long-acting opioids; use of the lowest effective dose when prescribing opioids; and avoiding the concurrent prescribing of opioids and benzodiazepines whenever possible.

Lest employers need further urging to involve themselves more directly in the opioid epidemic, the group offers some disturbing statistics from a recent survey. Among the 62 large employers queried, 60 percent “experienced at least one issue arising from prescription opioid drug misuse or abuse in the workplace,” with “some of the most common issues [being] increased medical or pharmacy costs for chronic opioid users (40 percent), increased absenteeism or missed work among chronic opioid users (40 percent) and employees overdosing on prescription opioids (18 percent).”

The group also says that it is hosting a multi-part opioid summit, “a series of bimonthly 2-hour sessions during which experts discuss the key challenges associated with the misuse and abuse of prescription opioids and strategies to prevent addiction.”