A panel that came out of the Workers’ Compensation Research Institute’s Annual Issues & Research Conference this week discussed how opioid use is actually decreasing in many states, which is great news. Titled “WCRI Opioid Research & How States Are Combating the Opioid Epidemic”, panelists discussed steps that have been taken to reduce the prevalence of opioids and cited specific examples of what has worked and what is still to come.
Dr. Vennela Thumala of WCRI, Dwight Lovan formerly of the Kentucky Department of Workers’ Claims, and Judge Omar Hernandez of the Massachusetts Department of Industrial Accidents discussed recent trends in the epidemic. Between 2010 and 2015 the frequency of opioids per claim has declined in most states. They say that PDMPs may have had a role in that, states that saw the largest reduction in average opioids per claim had very strong regulations, and required physicians to check the database before writing prescriptions to a patient. The CDC guidelines for prescribing opioids released last year also may have been a factor. The DEA reclassified Vicodin as a Schedule II drug in August of 2014. It had been a Schedule III drug before that, meaning there were fewer restrictions in prescribing it.
Mr. Lovan referenced a study that looked at the ten highest levels of prescription opioids in counties around the country. The data was from 2014. Eight out of the ten counties were located in Kentucky. The state established a PDMP but was not mandatory and TPAs, carriers and pharmacy benefit managers could not access it. In 2012 they passed a “pill mill bill” which required physicians to consult the PDMP before prescribing, and required patients who had been prescribed opioids to undergo drug tests. The state has seen pill mills decline dramatically.
In Massachusetts, the “Opioid Alternative Treatment Pathway” that the state is looking into may be a way to get injured workers off of opioids if both they and their insurer agree that they can find another way to manage their injury. The worker would be assigned a care coordinator to help them look at other solutions beyond opioid medication.
Read more about this session and others from the conference here.