Man-made epidemic – opioid medication and popular health

According to the U.S. Center for Disease Control and Prevention (CDC), the amount of prescription opioids sold in the country has nearly quadrupled since 1999. Opioids are pain-relieving drugs like oxycodone, hydrocodone, methadone and codeine and are the most expensive and most highly utilised for work-related injuries. In 2016, 13 of the top 25 workers’ compensation medications were opioids.1 Costs for opioids have risen by 51% between 2003 and 2011 in workers’ compensation medical claims. Already today, opioid addiction is a serious problem in parts of the US.

Almost 100 Americans die every day from an opioid overdose. The phenomenon impacts a wide range of professions, including sports. As early as 2011, a report was published accusing NFL team medics of overprescribing opioid pain killers. Now 1 800 former NFL players have sued the 32 NFL clubs for consequent drug dependence.2 Other professional groups, however, are also impacted. The increasing use of opioids leads to abuse. The users of prescribed opioid have a strong tendency to start utilising illegal drugs as well, such as heroin. For long an urban phenomenon, opioid addiction is now firmly established in more rural areas as well, compounded by a mounting heroin addiction rate.3 In McDowell county, West Virginia, there are now more drug-induced deaths than anywhere else in the United States.

Numerous factors are influencing the steep upturn in opioid addiction, and there is no real consensus among the experts as to the causes. Quoting the National Survey on Drug Use and Health, the Scientific American publication recently pointed out that “75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them – obtained from a friend, family member or dealer.” So the roots of the problem, according to some, are not changes in injury patterns or methods of treatment such as alleged liberal prescription practices. Indeed, according to the Scientific American, the real risk factors are to be sought elsewhere, such as in mental illness, child trauma, unemployment and social marginalisation.

Whatever the actual causes of the epidemic, the potential impact for the insurance industry could be serious, not only within the USA, but also in Canada, faced with a similar opioid epidemic.4 In both North American countries, the concern is growing. A recent ruling in West Virginia gives patients the right to sue physicians and pharmacies for enabling addiction. The rising cost of opioid use adds to workers’ compensation medical claim costs. Moreover opioids can heighten risks for users at their workplace and behind the wheel. And there have been recent lawsuits against distributors by states and other municipalities seeking damages for the economic impact these drugs have had in their jurisdictions.

Potential impact:

  • With opioids as a major cost driver, Worker’s Compensation in the U.S. may face a serious medical claims inflation.
  • An increase in medical malpractice claims may occur with doctors prescribing such drugs liberally.
  • Liability law suits may also be launched against the manufacturers and distributors of opioids, including pharmacies, resulting in bigger claims exposure of pharmaceutical and related companies.

This text is an excerpt from the "Swiss Re SONAR, New emerging risk insights", June 2017.

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1 http://lab.express-scripts.com/lab/drug-trend-report/workers-compensation-drug-trendreport
2 https://www.nzz.ch/sport/weiterer-sport/american-football-immun-gegen-schmerzenld.152062
3 https://www.nytimes.com/2016/03/07/us/heroin-epidemic-increasingly-seeps-into-publicview.html?_r=1
4 https://www.thestar.com/news/canada/2017/04/25/an-epidemic-within-an-epidemicwhy-opioid-use-in-canada-keeps-rising.html


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