Could Pills Pay Bills for Workers' Comp Patients?

When I started my career 20 or so years ago, some of the older pharmacists taught me that a workers’ compensation insurance patient was nothing a short of a drug seeker. It took me years to see these patients as far different from that, and I apologize for my youthful ignorance.

Like most of my patients, I’m happy to see those on workers’ comp. They require my services, and someone has to do what others consider dirty work.

While doing so, I learned a horrible truth from such a patient the other day that I must say repulsed me.

This patient wanted to get off of an opioid analgesic and a few other medications, but workers’ comp required the patient to stay on them in order to retain benefits.

“Take your pills and we’ll pay your bills,” is the message this conveys.

Wanting to stop a medication but not being able to do so because someone (a corporate insurance entity, in this case) won’t let you is tantamount to forcing you to take pills against your will. If this is somehow legal, I’m astonished.

There’s another hitch to this story: the patient wanted to use synthetic THC capsules for pain management. The problem is that most insurance companies will only pay for a maximum of 30 mg/day, despite the fact that it takes 60-plus to get the job done. But they’ll write a check for doses of opioids that were only used for end-stage disease just 25 years ago.

The patient told me that the health care field looks bad for letting this happen. At that point, I felt something that I’ve never felt throughout my entire career: shameful about what my profession has done to contribute to a problem. Physicians are pulling the trigger, but we’re the ones supplying the bullets.

I know there are patients who can’t function without their medications, and I’ll continue to serve them. However, I feel the need to advocate for those who want to get off of a medication but feel forced to stay on it. If those patients didn’t receive a medication, wouldn’t it save workers’ compensation money?

The sad thing is that pharmacists’ hands are tied by the medical and insurance professions, which also force some pharmacists to keep filling these kinds of prescriptions, at least until we’re told to stop.

Jay Sochoka, RPh, is sick of this cycle.