State legislators advance best practices guideline for opioids
"In the world of workers' compensation, there is significant proof that long-term opioid use leads to longer claim duration, longer-term disability, higher costs, and higher medical expenses," the document states. "The use of long-acting opioids, for instance, has been found to increase the cost of a workers' compensation claim by nine times. And according to the California Workers' Compensation Institute, the top one percent of prescribing physicians accounted for 41 percent of all prescriptions for Schedule II drugs."
The guide suggests strategies for prescription drug monitoring programs, physician prescribing practices, education and outreach, and treatment and recovery.
For example, the document suggests states weigh the concerns of all involved. "Legislators should work to ensure that the standards target inappropriate opioid use without negatively affecting clinical decision-making and legitimate treatment."
It also suggests the use of consistent, evidence-based treatment guidelines and that treatment guidelines offer alternative medications such as anti-inflammatory drugs.
The education and outreach section suggests that the general public, as well as practitioners, need to be educated about the problems of prescription painkillers. "After all, unlike heroin, cocaine, and other illicit drugs, prescription narcotics come from a trusted source -- a doctor."
The guide suggests states "encourage and enhance treatment and prevention initiatives."
"One aspect of an opioid strategy that legislators must not ignore is how to care for people suffering from drug overdose and addiction. The need to address such concerns is clear. Just one statistic: between 1999 and 2009, there was a 430 percent rise in the rate of treatment admissions for the abuse of prescription painkillers," according to the guide.
The NCOIL Workers' Compensation Insurance Committee is asking interested parties to submit comments or suggestions, to compare the draft guidelines against their own state statutes, and to take the proposal to their district attorneys.
"State legislatures deserve a great deal of credit for their wide-ranging efforts to tackle the opioid epidemic, particularly their work in recent years. Opportunities exist, though, to establish additional and perhaps even more successful reforms," the guideline concludes. "Best practices are not intended to be a final word on how states should approach a multi-faceted opioid strategy, but they hopefully do provide a starting point for legislative discussion and decision-making.The statistics of abuse are disturbing. States may have little time to waste."
By Nancy Grover
Read more at the WorkersComp Forum homepage.
August 30, 2013
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