September 11, 2017
Opioids in the Workplace

Data analytics, medical devices offer opioid alternatives

Photo | Contributed
Photo | Contributed
Biowave's neurostimulator is a pain relief device, and opioid alternative, used by the New York Giants football team.
Photo | Contributed
Travelersí National Medical Director Dr. Adam Seidner speaks at a recent opioids forum.

Like baseball, basketball and other arenas where data is invaluable, analytics has come to pain management.

Travelers Cos., a leading U.S. workers compensation carrier in Hartford, is using a proprietary predictive model — the first of its kind — to identify individuals most susceptible to chronic pain. In this way, clinicians and patients can take steps to prevent injuries, or prepare for surgery, and curb the need for opioids or other painkillers.

Travelers' patented "Early Severity Predictor," or ESP, was designed specifically for that purpose.

"The body can do amazing things to heal itself, but you have to have the right choices,'' said Dr. Adam Seidner, a physician and pain-management expert who is national medical director at Travelers.

Travelers says it manages more than 250,000 workplace injury claims and 3.5 billion medical treatments annually.

Since 2015, the insurer has applied ESP in more than 20,000 cases, identifying more than 9,000 injured workers who it says were at risk of developing chronic pain.

But rather than administer narcotics, these workers "received a customized, sports medicine-like regimen of treatment precisely sequenced to aid and accelerate their recovery,'' the company said.

The result, it said, was that injured workers who participated in the program in the past year have, on average, recovered and returned to work faster. Moreover, the few who were prescribed pain-relieving opioids got them at much lower dosages than is typical and for a shorter duration, Travelers said.

Finally, the average cost of employees' down time — nearly $40,000 per injury — was cut by as much as half, the insurer said.

"Helping employees avoid chronic pain and the slippery slope to possible opioid dependency is critical to reversing this disturbing and costly health crisis," Seidner said.

Other non-opioid options to managing chronic pain are already in use or on the horizon, experts say. These include body massages, acupuncture, aromatherapy and hypnosis. Nonsteroid pain-relievers and anti-inflammatories such as acetominophen, the active pain-reducing ingredient in brands like Tylenol, ibuprofen found in Aleve and Midol, and naproxen found in Advil, also are options.

Electro-mechanical and electronic neurostimulators, too, are being enlisted among the non-addictive options available to pain victims, who covet prompt relief without side effects.

In Norwalk, Biowave Corp. markets a patented technology that delivers temporary relief by disrupting nerve signals to the body's pain receptors in deep tissue, said founder Bradford Siff. The National Football League's New York Giants was Biowave's first customer; 30 of the league's 32 teams now deploy its devices to help players deal with pain from game injuries, Siff said.

"It's pain relief at the press of a button,'' he said.

Thirty-minutes of Biowave treatment just below the surface of the skin provides up to 72 hours of pain relief — triple the duration of comfort from more traditional transcutaneous electrical nerve stimulation (TENS) machines, technology that dates to the 1970s, he said. The BiowavePro is priced at $3,500; a smaller, home prescription version costs $895.

Biowave and older TENS technologies, Siff said, are among alternatives to easing pain symptoms. Implantable, battery-powered pain-management devices, too, are available, if not costly, at $50,000 to $80,000.

Giants head athletic trainer Ronnie Barnes confirms the team uses Biowave, along with other "passive'' pain-relief technologies, "to help provide short-term relief during chronic pain flare-ups and in controlling symptoms such as pain, inflammation and swelling. Biowave, TENS and similar modalities provide us with necessary options in pain management."

However, Travelers' Seidner says research has yet to prove the efficacy of neurostimulators, and cautions they may not deliver the full relief users' expect.

Siff, too, admits that Biowave and TENS machines are not "going to replace pills.''

View whole series here.

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