Workers’ compensation cases involve comprehensive medical records review to determine the nature of the injury and prescribe the right treatment. Often, workers injured on the job are prescribed opioids to deal with the pain. There has been considerable increase in the use of opioids in workers’ compensation over the past twenty years. For instance, a worker who hurts his neck and fractures his vertebrae in a workplace accident may be prescribed opioids. Opioids such as OxyContin, Morphine and Percocet are prescribed for pain related to workplace injuries, and often this leads to opioid addiction. Studies show that opioids are being prescribed for many conditions for which they were not originally intended. Realizing the seriousness of the situation, efforts are on across the United States to create opioid treatment guidelines, change medical practice patterns and control the opioids epidemic.
In Illinois, the workers’ compensation system has a weak point that puts injured workers at risk of drug overdose and addiction. Doctors treating injured workers in Illinois through the workers’ compensation system can sell the drugs they prescribe directly from their office. This may have dire consequences as Johns Hopkins researchers point out. When physicians are allowed to sell the drugs directly, they tend to prescribe more than three times the quantity of opioid drugs they would otherwise prescribe, according to the Johns Hopkins study. In addition, workers are off the job for 85% longer. According to the researchers, financial incentives must be the reason for this.
The state government has introduced measures to address this increasing opioids addiction. The Illinois’ Prescription Monitoring Program (PMP) requires pharmacies filing prescriptions to record the recipient’s name, address, and the drug supplied to a state database on a daily basis. The problem is, though pharmacies comply with this requirement, many physicians selling drugs directly from their offices do not. Physician-dispensing sites are not registered in the above mentioned database. What is the danger involved in this? A doctor treating an injured person who is already receiving physician-dispensed drugs from somewhere else may not be able to make a holistic judgment of the patient. As a result, the patient could very well end up receiving dangerous combinations of opioids.
According to the Workers’ Compensation Research Institute (WCRI), physician-dispensed drugs comprise more than 60% of the cost of prescriptions covered by workers’ comp in Illinois. They infer that this is due to the significant increase in the price per pill for physician-dispensed prescriptions. In fact, physicians sell drugs at triple the price of the typical dose at the pharmacy. This practice is a threat to injured workers and their families and communities.
Though 21 states in the U.S have taken steps to control physician dispensing of drugs within workers’ compensation laws or more broadly, Illinois has not. However, House Bill 2892 filed by state Rep. Barbara Wheeler is expected to address this issue. This bill would ban physician dispensing within the workers’ comp system while allowing limited exceptions for areas without access to a nearby pharmacy. It would help address a major worker health issue while saving on workers’ comp insurance costs for Illinois businesses.
A number of U.S states are working to restrain the overprescribing of powerful painkillers to injured workers, while also helping those who became addicted to avoid potentially fatal consequences.
- The most recent figures from the federal Bureau of Labor Statistics show that about 2.8 million private industry workers and 752,000 public sector employees suffered non-fatal workplace injuries in 2015, with more than half resulting in time away from work.
- CompPharma, an industry group that focuses on controlling workers’ compensation spending conducted a survey that revealed that more than $1.5 billion was spent on opioids by workers’ compensation insurers in 2015. Prescriptions for injured workers accounted for 13% of total opioids pharmacy costs in the United States that year. The survey respondents mentioned opioids and addiction as their most serious concern.
- A study of 337,000 workers’ compensation claims in 25 states published in 2016 shows that 55 to 85% of injured workers who missed seven days or more of work received at least one opioids prescription. Rates of longer-term opioids use differed widely among states – 1 in 6 injured workers in Louisiana, 1 in 10 in California, New York and Pennsylvania, but only 1 in 30 in Missouri and New Jersey.
Opioid abuse is a public health crisis that negatively affects injured workers and their families as well as communities. The states can introduce effective measures to control this serious problem, provide the best treatment and care to workers and implement rehabilitation programs to help workers who have become addicted to prescription painkillers. Rules such as those introduced by the Ohio Bureau of Workers’ Compensation that would deny reimbursement for opioid prescriptions if it is believed that physicians are overprescribing or otherwise failing to follow “best medical practices” in treating injured workers, are welcome initiatives in this regard. To address the opioid addiction problem, injured workers must become actively involved in their pain management. They should not take pills long-term that are going to lead to more harm than good. They can request the prescribing physician to discuss the medication plan with them, the adverse effects, and how to get off the drugs if they become addicted.
