IAIABC, ACOEM target state workers' comp agencies with opioid message

"The growing issue of prescription opioid abuse in the United States . . . has the potential to seriously impact the health and well being of our national workforce," says a letter sent to workers' comp agencies in all U.S. jurisdictions. It talks of an epidemic of prescription opioid abuse and urges recipients to become engaged in efforts to address the problem.

The American College of Occupational and Environmental Medicine and the International Association of Industrial Accident Boards and Commissions crafted the letter.

"The initial idea is to raise awareness," said Barry Eisenberg, ACOEM executive director, "and with the administrative staff of IAIABC, to provide some unity of messaging to say this is not just an administrative issue of cost that the IAIABC has identified, but one that has very strong empirical medical evidence behind it."

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Eisenberg said the idea to work with the IAIABC on the project came from occupational medical providers who see the growing problem of opioid abuse in the workers' comp system. While the letter says the organizations are not opposed to the "safe and controlled use of prescription drugs for pain relief," Eisenberg said he's not aware of any evidence that shows long-term usage of prescription opioids produces good patient outcomes.

"It doesn't produce good patient outcomes, it produces addiction," Eisenberg said. "Once you've gone through and studied the evidence, it just became obvious that as a matter of public policy, there's a large problem in the workers' comp system of overprescribing and usage of opioids."

In the letter, the organizations say they are writing to "express our deep concern" about the issue. "The abuse of prescription opioids has become a grave personal risk to injured workers, a disruptive force in the lives of those close to claimants harmed by abuse, and a cost concern to other stakeholders in the United States workers' compensation system."

It notes that several states have taken successful actions to "protect against drug abuse and misuse." It says there are a variety of different strategies being employed and the approach must be holistic.

"There's not one little thing, it has to be multifaceted -- state regulators working with the medical community and payers all interactively working on a solution," said Greg Krohm, executive director of the IAIABC. "The bottom line is [in the letter] we commend those states that have already taken action but say, 'if your state has not already, we suggest you do one of the two following: visit our resource page . . . second, participate in a webinar we're offering to IAIABC members to learn more about proactive steps states can use.'"

The IAIABC webinar Nov. 2 will be moderated by Joe Paduda, principal of Health Strategy Associates and author of the Managed Care Matters blog. The panelists will be Gary Franklin, the medical director for the state of Washington, and Kathryn Mueller, medical director of Colorado.

The webinar will focus on "what states can do to combat the opioid abuse problem," Krohm said. "So it will be nuts and bolts; what states have done."

The IAIABC's online resource page on opioids abuse in workers' comp cites Washington, Texas, and the California State Compensation Insurance Fund as agencies that have adopted successful strategies.

"One of the most important things is for a state to adopt evidence based medical practice treatment guidelines specifically pertaining to opioids," Eisenberg said. "ACOEM has a guideline. Others out there are equally good. The important point is for states to look at those and adopt one."

The two organizations hope the letter will persuade agencies to better understand and respond to the problem of opioid abuse in the workers' comp system.

"Our hope in initiating this is to raise the level of dialogue and get people to really think about the evidence and use that evidence in terms of developing the programs that make the most long-term sense," Eisenberg said.

Read more at the WorkersComp Forum homepage.

October 24, 2011

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