A study published last month in the Journal of the American Medical Association found that workers’ compensation claimants have a high proportion of persistent opioid use. A link to the study can be found here.
The report found that 30 percent of injured workers prescribed opioids are still taking them 3 months after their injuries; increasing the likelihood they will become addicted. For the study, the researchers collected data on nearly 9,600 injured workers who filed workers’ compensation claims in Maryland from 2008 to 2016. All patients were initially treated with opioids.
Nearly one third of injured workers in the study who initially treated with an opioid prescription continued to fill the prescription 90 days after the injury. Nearly 10% of the injured workers filled an opioid prescription beyond 365 days from their date of injury.
Persistent opioid use was significantly associated with increased age, pre-injury incomes of $60,000 or more, claims adjudicated as permanent total disability, and a diagnosis of chronic joint pain or another pain diagnosis such as migraines or fibromyalgia.
Workers who were 60 or older were more likely to be on opioids for more than 90 days, as were employees who did not have full-time employment prior to their injury.
The study authors also pointed a finger at the worker’ compensation system itself:
“The design of the Maryland Workers’ Compensation system is to allow disputes over medical issues to be adjudicated in a legal setting. The decisions may reflect the nature of the medical supporting documents and presentation as the basis for a legal decision rather than an accurate reflection of the medical condition. Continued prescriptions for pain management can be used to legally support a continued injury claim. Also of note is the strong association between unspecific types of injuries and persistent opioid use. A lack of specificity in diagnosis may prolong delays in treatment, recovery, and return to work.”
What is Ohio doing to solve this problem?
I’ve written before about what the Ohio legislature has done to try and address the issue of opioid use in workers’ compensation claims. Two of those measures include changes to the Ohio Administrative Code. One of those changes requires that, with some exceptions, in the “subacute phase of pain treatment” (pain lasting more than 6 but less than 12 weeks following the injury or following surgery), opioid prescribing or dose increases that do not result in a “clinically meaningful improvement in function” should not be approved. A link to that post can be found here.
The legislature also introduced procedures by which employers may unilaterally terminate payment for ongoing prescriptions in claims. A link to that post can be found here.
Ohio has made a concerted effort to address the opioid issue and should be congratulated for its efforts. More work still needs to be done, however.