A study of opioid use among workers' compensation claimants reveals that longer-term use increased in nearly half of the 21 states analyzed compared to a similar study conducted a year ago.
The study, “Longer-Term Use of Opioids,” conducted by the Workers Compensation Research Institute, finds that longer-term use–defined by WCRI as claimants who were prescribed opioids within the first three months after a non-surgical injury and had three or more visits to fill opioid prescriptions between 7 and 12 months after the injury–increased in 10 of the study states, with the highest year-to-year increases in Arkansas (3 percent increase), Michigan (2 percent) and New York (2 percent).
New York and Louisiana showed the highest increases over a two-year period (3 percent).
Louisiana and New York also recorded the highest overall percentage of non-surgical claimants who were defined by the study as longer-term users (17 percent and 14 percent respectively). By contrast, Arizona and Wisconsin showed the lowest percentage of longer-term users (3 percent and 4 percent respectively).
The study period involves claims for non-surgical injuries occurring from Oct. 1, 2008 through Sept. 30, 2009, with opioid prescriptions filled through March 31, 2011.
Aside from the 10 states that showed 1-3 percent increases in longer-term opioid use, WCRI says Massachusetts was the only other state to record a meaningful change compared to last year's study. In Massachusetts, longer-term use fell by 3 percentage points year-over-year and by 4 percentage points over a two-year period. Overall in Massachusetts, 7 percent of non-surgical claims with prescribed opioid use were identified as longer-term users.
The study notes the observed decrease in Massachusetts represents a trend reversal. The percentage of claims with longer-term opioid use had increased by 2 percent from 2006-2007 before decreasing by 4 percent over the following two years.
Explaining the decrease, WCRI says, “In the past few years, Massachusetts has made several regulatory efforts to prevent opioid overuse and misuse, including a mandatory education program, sponsored by the Board of Registration of Medicine, for physicians who prescribe controlled substances, and the enhancement of the [utilization] of the state PDMP [Prescription Drug Monitoring Program].”
WCRI notes, though, that “more rigorous analysis” is needed to confirm it's conclusion about the trend reversal in Massachusetts.
In general, across the 21 study states, WCRI says, “We found that longer-term use of opioids continued to be prevalent in workers' compensation, especially in Louisiana and New York, as well as Texas, Pennsylvania, South Carolina, California and North Carolina.”
Noting the motivation behind its study, WCRI says, “The dangers of opioid misuse resulting in overdose deaths, addiction, and diversion constitute a top priority public health problem in the United States.”
WCRI adds that about 55-85 percent of injured workers receive opioids “despite medical recommendations to avoid routine prescription and to limit the use of opioids to more severe pain or pain which is unresponsive to other analgesics.”
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