Managing pain can be a difficult task for injured workers who don't want to be subject to long-term opioid use, and the risks that those drugs pose.  Doctors are much more careful in prescribing opioids, especially in light of the opioid crisis that has plagued the United States the last 10-15 years.  So how does the doctor manage an injured worker's chronic pain? 

Recently, there has been a growing trend of prescribing neurological drugs normally approved for epileptic conditions, such as gabapentinoids, for managing pain arising from work-related injuries. Some doctors utilize these drugs in place of opioids, and as an "off label" alternative method for pain management.  However, risks arise when the prescription regimen of some injured workers includes opioids, which are being prescribed along side these gabapentinoids.  

The Cambridge, Massachusetts-based Workers’ Compensation Research Institute studied prescription trends across 28 states, and found that workers with gabapentinoids often received opioids concomitantly, which increased the risk of respiratory depression, resulting in overdose deaths. Therefore, monitoring an injured workers' medication regimen is an absolute must for doctors, [and insurance carriers as well], in order to make sure risk of greater harm is mitigated. This is not to say that gabapentinoids or opioids should be avoided.  They can provide great relief to many injured workers who legitimately suffer from long term chronic pain.  But caution should be heeded when an injured worker is prescribed both.