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Feb
28

WCRI on Opioids – Part Two – Opioids in WC

Senior researcher Dr. Dongchun Wang’s presentation delved into the details, looking at data from 300,000+ non-surgical lost time claims, with scripts filled thru March 2011.  I emphasize non-surgical, as its entirely understandable that a patient just out of surgery would get some opioids to help them deal with post-surgical pain for a few days.

Takeaways…

  • Why are so many non-surgical claims getting opioids?  With rare exceptions, opioids are NOT indicated for these types of claims. Who’s prescribing these drugs and why is this allowed?
  • Building off yesterday’s discussion of variation in prescribing patterns, we’ve seen huge variations in prescribing patterns – dosage, duration, long-term vs short term usage.
  • The volume of opioids received per claim varied by a factor of four among the study states – lowest in Iowa, and highest in NY (on a morphine equivalent basis)
  • In four states, more than ten percent of claimants who received opioids were still getting scripts six months later – and remember, these are non-surgical cases.  While only 3% of AZ claimants were using drugs for more than six months, 17% of those in LA were…
  • 24 percent of drug claimants were tested in 2009/2011; a big improvement over the 14 percent from the previous two-year period – but still abysmal. (disclosure – Millennium Labs, a drug testing firm, is a consulting client)
  • As bad as that rate was, it was better than the use of psychological evaluations which should be done prior to prescribing – only 7 percent of claimants had psych evals…

 


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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