Questions and Answers from Dr. Jacob Lazarovic, Chief Medical Officer at Broadspire about urine testing program done in conjunction with prescription of controlled substances.
Recently, there has been a growing concern about the significant misuse, abuse and diversion risk associated with the prescribing of controlled substances. A national study found that 71% of workers’ compensation claimants on chronic opioid therapy (>3 months) aren’t taking their pain medication as prescribed1. Dr. Jake and his medical management team have worked on creating a urine drug monitoring (UDM) program and Dr. Jake has answered questions on the subject.
1Bulletin to Management, 12/5/2002, BNA Professional Information Center
Q: How do you identify workers who need urine drug monitoring?
We mine our data and flag those claims with chronic opioids, excessive pain management/addictive substances, high cost outliers, and several other criteria. Our claims professionals and senior nurse reviewers also single out appropriate claims for the program. We then confer with the providers to decide whether UDM should be recommended.
Q: What is the process for drug monitoring and who performs the tests?
After we identifiy the claimant for UDM, we send a request to our partner Ameritox and the provider. Only the treating doctor can order the test and the patient must agree to comply. The physician then collects the specimen and ships it to the lab. After the tests are complete, the lab sends a report to both the physician and the Broadspire team. If there are inconsistencies or concerns, our medical management team confers with the provider about resources and interventions available. The provider discusses the tests results and options with the employee. (WCxKitz)
Q: What resources help combat prescription drug abuse or misuse?
We have a gamut of services that can help depending on the case. Our telephonic or field case management may be appropriate to help educate an employee on proper prescription use. We have Chronic Pain Management where a panel of specialists creates full treatment plans to help employees deal with their pain. Our Narcotics Program can help manage opioid usage. Many of these options include psychological services such as behavioral therapy or addiction management available to employees.
From the BROADSPIRE REVIEW – June 2010. Printed with permission
Author: Withover 25 years of experience, Broadspire’s Chief Medical Officer, Dr. Jacob Lazarovic, is one of the most respected physicians in the workers’ compensation medical community. Contact at: AskDrJake@choosebroadspire.com
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