Injuries cause pain. Each one of us has experienced this. Usually, we experience minor injuries and the pain goes away quickly. The only pain medication we take is ibuprofen or acetaminophen.
Unfortunately, many workers’ compensation injuries cause pain that is more severe and lasts longer. When doctors treat these injuries, they often recommend prescription strength pain medication to treat the pain.
Workers’ compensation doctors sometime recommend opioid medications. People also refer to these types of medications as opiates or narcotics. Lorcet, Percocet, and Oxycontin are some of the most well known brands of opioids.
Doctors also prescribe non-narcotic medications to treat pain. The decision about the best way to treat your particular pain is a decision best made by your doctor.
Is it dangerous to take pain medication?
That depends. All medication has some risks. Your doctor and your pharmacist can talk to you about some of the specific risks of taking a particular medication. Also, the Physicians Desk Reference provides a general overview of medications including the warnings that should be on the medication packaging.
Regarding opioids specifically,I found out a lot about opioids recently when I was asked to speak on a panel with a doctor and another attorney at a continuing legal education seminar. That panel discussed pain medications in workers’ compensation cases.
What are the risks associated with taking opioids
I am not a doctor. I am a lawyer. Medical professionals can better tell you about the risk of taking opioids.
Recent studies have shed some light on the risks of taking opioids. There is concern about when doctors should prescribe opioids and the proper dosage.
The Center for Disease Control (CDC) has some excellent information about opioids. They recently prepared guidelines with recommendations for primary care doctors prescribing opioids.
Doctors often talk about opioids in terms of morphine equivalent doses (MED) or morphine milligram equivalents (MME). Doctors can use the CDC calculator to determine the amount of MMEs from different opioid prescriptions.
The CDC made recommendations in 2016 regarding MMEs. They recommended using extra caution when exceeding 50 MMEs per day. They also recommended that primary care doctors avoid or carefully justify opioid doses of greater than 90 MMEs per day.
Why did the CDC make these recommendations?
The CDC guidelines discuss the recommendations in a lot of detail. The primary reason for the recommendations seems to be new evidence indicating risks associated with higher MME opioid dosages.
These risks include increased risk of overdose and potential increased risk of addiction. The CDC reports several studies that shows increase risk of overdose and increased risk of overdose death with higher dosages of opioids.
Guidelines for opioid prescriptions existed prior to the CDC Guidelines. However, the CDC indicates that these prior guidelines from medical associations and other groups varied widely in their recommendations regarding appropriate MME dosage. The CDC hoped to make a more uniform standard using information from the most recent scientific studies.
Should Georgia change its workers’ compensation laws to address the opioid problem?
As an attorney who represents people injured at work, I try to make sure my clients receive the best possible medical treatment. Insurance companies make it more difficult to receive that treatment each year.
While opioids have risks, they also have significant benefits. Doctors use them to treat pain effectively. Getting the medical treatment you need is one of your fundamental rights in a workers’ compensation case. Among other things, you have a right to medical treatment which cures you or gives you relief.
Doctors cannot cure some people. People with serious injuries often end up with some degree of permanent impairment and pain. If opioids effectively relieve pain for a serious injury, I want my clients to have that treatment option available.
How might changes in the law affect injured workers?
If Georgia’s workers’ compensation laws are changed to make it more difficult to get treatment with opioids, then people injured at work will suffer. Insurance companies could use these types of laws to avoid paying for medical treatment. In other words, insurance companies would save money while injured workers suffered additional pain.
All medications have risks. Actually, all medical treatment has risks. The question for the doctor and the patient is often about balancing the risk against the reward.
The CDC guidelines attempt to balance risk versus reward by making recommendations about what doctors should do when prescribing opioids in certain situations. Hopefully, these guidelines will help doctors and their patients to make good decisions about treatment of chronic pain.
Are there risks associated with taking other pain medication?
Doctors use pain medication other than opioids to treat pain. One option for pain treatment is a muscle relaxant like Flexeril (cyclobenzaprine). Another type is a medication that treats neuropathic pain like Neurontin (gabapentin).
Sometimes, doctors prescribe these medications by themselves. Other times, these medications are prescribed in conjunction with other pain medications.
Some people hear about the risks from opioids and believe that these non-opioid pain medications do not have risks. You should understand that non-opioid medications have risks. As I stated earlier, all medications have risks.
Of course, you will have to balance these risks against the pain you suffer from your injury. If the medications provide you significant relief, you may choose to accept those risks in order to get some relief from your pain. The best thing to do is to talk to your doctor and understand the risks so you can make the best decision.
Are there other ways to treat pain other than pain medication?
Doctors treat pain in many different ways. They try to cure it through rest, physical therapy, and interventional treatments like surgery. They try to manage it with medication and interventional treatment when they cannot cure it.
You may find it helpful to explore options other than medications to treat your pain. Some of the nonmedication treatments provides by pain management doctors include:
- Epidural steroid injections
- Medical branch blocks
- Facet injections
- Radiofrequency ablations
While these interventional treatments may not cure your pain, they may reduce it to the point that you can manage it with medication. Also, you may reduce the medication you take.
Obviously, doctors need to make the recommendations about the best way to treat your pain. Just be sure you are aware that there are different options for pain treatment. This way, you can make sure that you receive the best possible treatment for your pain.
Jason Perkins is an attorney who specializes in representing injured workers. He regularly blogs about Georgia’s workers’ compensation system and issues that are important to injured workers and their families.
You can subscribe to his Georgia Workers Compensation channel on YouTube.