Chronic pain is by far the most debilitating—and for claims payers the most costlycompensable condition in workers’ compensation, according to a new special report from WorkCompCentral.

The report chronicles the way opioid use greatly expanded in workers’ comp over the last 20 years, then halted and is now in retreat as a result of increased criticism and research into its efficacy. The report also provides practical suggestions to rethink the approach to chronic pain—that is, pain that persists beyond expected healing time.

Opioids are defined as medications that relieve pain by reducing the intensity of pain signals reaching the brain, for example, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), morphine and fentanyl. Although some use the term “narcotics” to refer to these drugs, it’s a less precise term.

Startling statistics

Generally, most medical care for injured workers poses “trivial” or no iatrogenic risk (risk that medical treatment will inadvertently cause illness or death). This is not the case when opioids are used for ongoing treatment, however. According to the report, workers on a medium-to-high dose of opioids for a year experience about 1.75 deaths per 1,000 patients per year. By comparison, the riskiest jobs in the U.S., such as logging…