The News You Need for March 1
We wrap up the latest emotions series, consider the EEOC and where its going on pregnancy accommodations, and learn about ketamine.
Processing the Injury and Coping: Understanding the Emotional Challenges of Recovery?
As we conclude?Segment Two: Processing the Injury and Coping, we reflect on the deep emotional struggles that arise when recovery is not as smooth or predictable as hoped. Unlike the immediate emotional responses to injury—fear, shock, confusion, and vulnerability—this phase explores individuals' longer-term emotional weight as they navigate limitations, delays, and setbacks in healing.?
The emotions in this segment—sadness, grief, hopelessness, resignation, anguish, disappointment, regret, discouragement, and frustration—reflect the complexity of the healing journey. While these feelings can be overwhelming, they are not roadblocks but signals urging attention, care, and adaptation. Recognizing and understanding them helps individuals reframe their struggles, regain perspective, and move forward with resilience.?
Reflecting on the Emotional Barriers to Recovery?
Each emotion explored in this segment uniquely impacts the recovery experience, shaping how individuals process?loss, setbacks, and uncertainty. These emotions do not appear in isolation—they overlap, feed into each other, and profoundly shape the recovery experience. Recognizing them as natural and valid allows individuals to process them without feeling stuck in negativity.?
Key Takeaways from Segment Two?
Emotions are a normal part of the process.?No one moves through recovery without experiencing?emotional highs and lows. Understanding these emotions can help individuals manage them?rather than be consumed by them.?
Self-awareness creates strength.?The more individuals?recognize and name their emotions, the more control they gain over how they respond. Acknowledging frustration or discouragement can?shift it from a roadblock to a signal for adjustment.?
Healing happens at different paces, and no two recoveries look alike. Some individuals regain abilities faster than expected, while others experience unexpected complications. Accepting a personalized, flexible timeline reduces unnecessary distress.?
Support is essential. Family members, caregivers, and even employers are critical in helping individuals manage emotional distress. Small gestures of encouragement and validation can make a significant difference.?
Growth comes through challenges. While difficult, these emotions offer opportunities for emotional resilience. Working through frustration, grief, or disappointment builds strength beyond recovery.?
An Invitation to Reflect?
The recovery journey is deeply personal. No two individuals will process emotions in the same way. But by understanding these emotional complexities, we can help shape a recovery environment based on patience, empathy, and resilience.?
For those navigating recovery, take a moment to reflect:?
For caregivers, supporters, or employers:?
Looking Ahead to the Next Phase?
With this article, we conclude?Segment Two: Processing the Injury and Coping—an exploration of the emotions that arise when individuals grapple with setbacks, delays, and unexpected challenges in healing. While this stage is often filled with uncertainty, it is also a pivotal moment in recovery.?
From here, we shift into?Segment Three: Adjusting to the New Normal. This next recovery phase focuses on emotions tied to acceptance, resilience, and adapting to a changed reality. Instead of looking back with sadness or frustration, individuals redefine their sense of self, explore new possibilities, and embrace a future that still holds meaning.?
This next stage is about reclaiming agency over one's life, finding new sources of confidence and fulfillment, and learning that recovery may alter a person's path but does not erase their potential.?
As we continue this journey through the emotional dimensions of workers' compensation and injury recovery, we create a space where?humanity, resilience, and empowerment are prioritized. That is the type of?workers’ compensation landscape I am here to support, educate, and encourage.?Join me!?
The Role of Ketamine in Pain Management for Workers’ Compensation
Developed in the 1960s as an anesthetic, ketamine quickly became a staple in emergency and battlefield medicine. Its ability to act as a powerful, rapid-acting anesthetic was vital for surgeries and acute care, particularly in situations where other anesthetics were unavailable or impractical. Today, while it remains?U.S. Food and Drug Administration?(FDA)-approved for anesthesia, ketamine is being used off-label for chronic pain management and mental health disorders, particularly for patients who have not responded to traditional treatments. Many injured employees suffer from long-term pain, and traditional treatments, especially?opioid-based therapies, have led to issues with dependency, addiction and even overdose. Ketamine offers a different mechanism for pain relief, working through N-methyl-D-aspartate (NMDA) receptors in the brain rather than opioid pathways, which has the potential to reduce opioid reliance in pain management protocols. Despite these benefits, ketamine faces significant stigma. Much of this stems from its misuse as a recreational drug, where it is referred to as “Special K” due to its hallucinogenic properties.?This association has led to reluctance among both patients and providers to consider ketamine as a legitimate treatment option. However, the medical use of ketamine is far removed from its illicit use. Administered in a controlled, clinical setting, ketamine is effective, particularly for patients who have exhausted other options.? For patients experiencing chronic pain, particularly those who have failed to find relief through opioids, ketamine can be a game-changer.?Studies?have demonstrated that ketamine is effective for chronic pain, particularly neuropathic pain. In workers' compensation, this could mean a faster, more effective route to recovery for injured employees, reducing disability duration and improving quality of life. Beyond pain, ketamine is gaining recognition for its rapid and effective treatment of mental health conditions, particularly depression and?post-traumatic stress disorder?(PTSD). Many individuals who experience severe injuries also face mental health challenges, from anxiety to depression and PTSD. Ketamine has been shown to improve symptoms of depression quickly, often within hours or days, compared to traditional antidepressants, which can take weeks to take effect. For injured employees, this dual benefit of pain relief and mental health improvement could offer a comprehensive approach to recovery.
As attitudes toward ketamine evolve and more clinical trials are conducted, its acceptance in pain management and mental health treatment is likely to grow. This shift may lead to increased use of ketamine as an alternative to opioids in workers' compensation programs. With its potential to manage chronic pain and address mental health issues, ketamine could significantly impact the recovery of injured employees. Staying informed about its benefits will be essential for both clients and adjusters as the landscape of treatment options continues to change.
About the author
Christina graduated with her Doctor of Pharmacy degree from the University of Arizona in 2010 and became board certified in ambulatory care in 2015. She has 5 years’ experience in workers compensation focusing on clinical programs and formulary management. Prior experience includes inpatient psychiatric rehabilitation and community-based health clinics.
Christina is also a regular contributor to the Ask the Pharmacist Series where this article originally appeared.
References:
https://adaa.org/sites/default/files/Ketamine%20JAMA%20Journal%20Article%20-%20Charlie%20Nemeroff.pdf https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.12094
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2011.03576.x https://onlinelibrary.wiley.com/doi/full/10.1111/cns.12111 https://www.sciencedirect.com/science/article/pii/S0165178123001166
How’s the EEOC Feeling about PWFA Regs? Acting Chair’s 2024 Letter Drops Hints
Labor Landscape
As happens when administrations turn over and the party in the White House changes, at the moment, Biden-era federal regulations stand to face scrutiny, scrapping, or irrelevance under the Trump agenda.
One set of rules almost certain to face changes soon are those implementing the Pregnant Workers Fairness Act, which became effective last June. Although Biden-era guidance on the new regs appears to still be in effect – and up and running – the EEOC also seems to indicate that its current position toward the rules is captured in a letter then-Commissioner Andrea R. Lucas wrote in opposition to the regulations.
Lucas, who is now the EEOC’s acting chair, used the letter to reject the new rules as going too far to accommodate “the female sex.”
Here’s a look at what Lucas had to say about the regulations.
Title VII?
Lucas’s letter faults the EEOC for “importing” Title VII discrimination standards into pregnancy accommodation law when the preamble to the regulations indicated that “pregnancy, childbirth, or related medical conditions” had the “same meaning as under Title VII,” a position Lucas opined had little support among courts or in administrative guidance.
“Having purported to bridge the [Pregnancy Discrimination Act] and the PWFA through an excerpted common phrase, the Commission then shoves broad concepts of unlawful pregnancy discrimination under Title VII into the PWFA, an accommodation statute designed to allow pregnant women to remain at work,” Lucas wrote. “The final rule opens the door to requiring accommodations potentially extending to a myriad of conditions ranging from infertility to menstruation to hormone issues to menopause.”
The problem, for Lucas, is that the rule requires an “obligation to accommodate any medical condition related to” a current pregnancy, past pregnancy, potential or intended pregnancy, infertility, fertility treatment, or use of contraception.
So, What is Lucas’s Answer?
The rules need to be reined in, according to Lucas, and “pregnancy” should have the “ordinary meaning of “the state of being pregnant, the period in which a child develops inside a woman’s body.” Perhaps ironically, the letter cited a National Institutes of Health website on the definition of pregnancy that was pulled down when the Trump administration took over.
Nonetheless, in Roe v. Wade-esq timelining, Lucas would limit “related medical conditions” covered by the PWFA to “conditions related to an actual current pregnancy of the worker, the worker’s childbirth, or a pregnancy or childbirth that has ended and the worker is in the postpartum period.”
‘Narrow Accommodation Gap’
According to Lucas, in the PWFA, Congress attempted to “fill a narrow accommodation gap between Title VII and the ADA.”
“Minor, simple, temporary accommodations for pregnant workers—such as water, food, and a place to sit while working—would allow women to remain working further into their pregnancies, if they wish to do so,” Lucas wrote. “These often temporary and simple accommodations should not require the full apparatus of documentation attending disabilities under the ADA.”?
Whether the Trump administration ultimately follows the letter’s lead in its approach to the regulation, it’s safe to say that the current chair won’t be pushing hard for enforcement of rules that she voted to disapprove.