When doctors prescribe strong opioids to injured workers, the assumption is the workers need them.
But when Florida banned physicians from selling strong opioids to injured workers, this did not translate into more scripts for pharmacies to fill.
“When we compare pre- and post-reform prescribing practices, it appears that physician-dispensers not only reduced their dispensing of strong opioids, but also reduced prescribing of strong opioids,” Richard Victor, WCRI’s executive director, said in a statement.
“This raises concerns that a significant proportion of pre-reform physician-dispensed strong opioids were not necessary, which means injured workers in Florida were put at greater risk for addiction, disability or work loss, and even death,” he added.
The WCRI study is important because it confirms what many of us
in Comp Land have been suspecting all along.
Specifically, patients receiving physician-dispensed weaker pain medications – non-steroidal anti-inflammatory medications such as Ibuprofen — went up from 24.1 to 25.8 percent. The percentage of injured workers who received weaker but legal opioids increased from 9.1 to 10.1 percent.
The study defines “strong” opioids as those on the U. S. Drug Enforcement Administration’s Schedule II ( i.e. Codeine, Hydrocodone) and Schedule III opioids, (i.e. products containing no more than 90 milligrams of codeine per dosage unit such as Tylenol with Codeine® and buprenorphine (Suboxone®). “Weaker” opioids are Schedule IV drugs that include carisoprodol (Soma®) and diazepam (Valium®).
Only two percent of injured workers taking weaker physician-dispensed pain medications in the first six months received stronger opioids from the pharmacy afterwards.
Physician dispensing of medication is a huge workers’ comp pet peeve of mine, as I covered in previous blogs.
This WCRI study is important because it confirms what many of us in Comp Land have been suspecting all along. When doctors can make money on stronger opioids, they will dispense them to injured workers even when safer alternatives work just as well.
Given the danger of opioid use and our nation’s opioid epidemic, I can only hope that this study gets the attention of lawmakers who have the guts to put injured workers before physician profits.
Oh, and here’s the fine print. The study is based on data concerning the medications dispensed for injured workers under the Florida workers’ compensation program. The claims were divided into two groups: pre-reform, with dates of injury from January 1, 2010 to June 30, 2010 (prior to the July 1, 2011, effective date of the ban) and post-reform, with dates of injury from July 1, 2011 to December 30, 2011 (immediately after the ban). The data included 24,567 claims with 59,564 prescriptions in the pre-reform group and 21,625 claims with 52,747 prescriptions in the post-reform group.
For more information about this study or to purchase a copy, visit http://www.wcrinet.org/result/PD_opioid_result.html