Studies Examine Prescription Painkiller Use Among Injured Workers

By Bill Leonard Oct 6, 2014
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The Workers Compensation Research Institute (WCRI) recently conducted two studies to get a clearer picture of how opioid-based pain medications are prescribed to workers who were injured on the job. Opioid drugs, such as morphine, oxycodone and hydrocodone, are effective pain relievers but also can be highly addictive.

The WCRI researchers discovered that the number of prescriptions for opioid-based drugs has held fairly steady in recent years. The researchers identified nearly 265,000 workers’ compensation claims filed in 25 states from October 2007 to September 2010, then tracked more than 1.5 million prescriptions filled through March 2012 that were related to the workers’ comp claims. Three out of every four injured workers received some form of opioids for pain relief.

The 25 states in the study represent more than two-thirds of the workers’ compensation claims filed in the U.S. every year.

“The number of prescriptions for opioid drugs did not increase or decrease substantially through that time period of the study, which is good news,” said Dr. Vennela Thumula, a policy analyst for the WCRI. “However, the number of prescriptions for opioids and the duration of the prescriptions remained fairly high.”

Injured Workers Not Receiving Standard Treatments

The WCRI also examined how often the services recommended in medical treatment guidelines were used for monitoring and managing workers’ chronic opioid therapy. Again, the study showed that the number of workers who received prescriptions for opioids three months and six months after their injuries remained steady. However, variations existed among the states, such as the number of prescriptions provided and the number of pills offered per prescription. Louisiana, Texas, Pennsylvania and New York had significantly more injured workers who had long-term (more than six months) opioid use.

“The variations … are there so it’s clear that some states are not following standard practices,” said Dongchun Wang, a WCRI economist.

The most significant finding of the study, according to Wang, was that the vast majority of injured workers with long-term opioid use did not receive standard treatments for chronic opioid-use management, as recommended in medical treatment guidelines, such as drug screening, psychological evaluations and physical therapy. Successful treatment of chronic opioid usage is in the interest of all employers, Wang added, because excessive use of opioids leads to an increase in work-related accidents and injuries.

“So it’s very important that employers and workers’ comp administrators make sure that injured workers receive the standard recommended treatments,” she said.

Opioid Use Higher in Louisiana, New York

A separate WCRI study examined the interstate variations of narcotics use and found that the amount of opioids prescribed for workers’ comp claims in Louisiana and New York was significantly higher than the other 23 states.

According to Thumula, the study only examined the number and duration of prescriptions, so it was unclear why opioid usage in some states was significantly higher or lower.

“All we can determine from this is that it can’t be standard use if the numbers are much higher,” Thumula said. “The usages in Louisiana and New York, for example, are twice the median rate and four times higher than the states with the lowest usage rates.”

Bill Leonard is a senior writer for SHRM.​

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