Research finds statewide opioid monitoring systems can reduce overprescribing and potential abuse.
A new study conducted by the Workers Compensation Research Institute suggests that certain types of programs and policies concerning opioid treatment and prescription monitoring may help tackle the issue of excessive prescribing of addictive painkillers and potential abuse. More specifically, researchers took a closer look at initiatives designed to track opioid prescriptions at the state level.
The study examined data on employee injuries in 33 states from October 2009 through March 2018. Information was collected from those injured in the following states: Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. “These states represent 85 percent of benefits paid in 2017,” according to the study.
The team compared outcomes of must-access prescription drug monitoring programs as well as limits on the duration of initial opioid prescriptions with states that do not have these procedures in place. Must-access prescription drug monitoring systems are used by providers to check a patient’s prescription history before issuing a new script. The data is statewide, meaning that providers can gather information even if a patient has moved, is going to multiple providers simultaneously, or has established care with many across the state.
Results show must-access prescription drug monitoring programs reduced the amount of opioids being prescribed by “12% in the first year,” and these regulations “resulted in a 19% decrease in the amount of opioids among claims with opioids” overall, according to researchers. The policies also led to more use of non-opioid pain medications for pain in cases of neurologic spine pain.
“The policies examined were part of an extensive effort by stakeholders at local, state, and national levels to address potential excessive opioid prescribing and opioid abuse,” WCRI President and CEO John Ruser said. “Must-access PDMPs reduced the amount of opioids prescribed to workers without changing the likelihood that workers had any opioid prescriptions.”
The results suggest that if workers know opioid use is being monitored, they are much less likely to try to get multiple prescriptions from multiple providers, and more likely to use non-opioid pain relievers altogether, particularly when it comes to work-related neurological injuries.
A study performed last year that examined the work-related injuries and opioid use suggested, “Organizational policies that reduce ergonomic risk factors, respond effectively to employee health and safety concerns, provide access to nonpharmacologic pain management, and encourage early substance use treatment are important opportunities to improve outcomes. Organizational barriers can limit disclosure of pain and help-seeking behavior, and opioid education is not effectively integrated with workplace safety training and health promotion programs.”
That study, published in the American Journal of Public Health, indicated, “Opioids are frequently prescribed for pain control after occupational injuries, although the rate is gradually declining. Recently, the efficacy of opioids to provide more than modest, short-term pain control for chronic noncancer pain has been called into question and taking opioid pain medications for more than a few days is associated with more disability and longer work absences in workers’ compensation, an effect that is not specific to occupational injuries.” The team found overall, “Opioids accounted for 61% of drug-related deaths among workers with lost-time work injuries.”
Study data can help guide those prescribing to ensure that there are safety measures in place to help reduce the nationwide opioid epidemic.