The escalating incidence of addiction to painkillers among injured workers is an alarming problem in workers’ compensation practices, according to Bob Steggert, vice president of casualty claims at Marriott, and Mark Sidney, senior vice president and general claims manager for insurance provider Liberty Mutual.

Occupational health researchers concur. “Prescription of opioids for nonmalignant musculoskeletal pain has increased substantially in recent years,” wrote researchers from the University of Washington’s Department of Environmental and Occupational Health Sciences in Seattle in an October 2006 article in the medical Journal of Pain.

Because of the nature of many work-related injuries, painkillers and anti-inflammatory medications are the top drug group prescribed, representing 52 percent of total prescription-drug payments in 2003, according to the National Council on Compensation Insurance (NCCI), a workers’ compensation research firm in Boca Raton, Fla.

If employees become addicted to prescription painkillers, for example, whether through poor doctor prescribing habits or insufficient employer oversight, the addictions can cause a lifetime of problems.

Regular use of several of the commonly prescribed painkillers on NCCI’s top 20 list can cause patients to become physically dependent or addicted to the medications, according to Sidney. If a worker becomes addicted to a painkiller during treatment for a work-related injury, the employer or insurance provider is also responsible for the cost of dependency treatment, Sidney adds.

The fourth most commonly prescribed drug on NCCI’s list of top 20 prescribed medications by total amount paid in workers’ compensation, for example, is OxyContin, a powerful narcotic pain reliever that can cause physical dependence with daily use.

Another commonly prescribed drug for workers’ compensation is Actiq. According to the manufacturer, Actiq should be used only for cancer pain by patients who are already tolerant of opiates. Actiq, which is taken in lollipop form, is not only extremely expensive—up to $10,000 per year per patient—but also highly addictive. Although the manufacturer and the U.S. Food and Drug Administration have approved the drug only for cancer pain, some physicians prescribe Actiq for pain in workers’ comp patients.

Steggert says Marriott wanted to tackle the addiction issue not just because of the tremendous costs involved for the company but also because avoidance of painkiller addiction is clearly in the best interest of the employee. Research from the American College of Occupational and Environmental Medicine, a Chicago-based medical society that promotes worker health, has shown that pain medications can delay injured workers from returning to work and can slow recovery.

To tackle painkiller addiction, Steggert worked with Marriott nurses and medical experts to develop a comprehensive opioid treatment abuse program.

Steggert will rely on reports from First Script Network Services, a pharmacy benefits management company for Marriott, to help measure success of the new workers’ comp program. First Script uses sophisticated databases to track medications, dosages, frequencies, and abnormal or inconsistent trends such as prescriptions for medications with addictive potential or medications unrelated to workers’ injuries.