Fewer injured workers are receiving opioids, and more are receiving non-opioid medications (e.g. NSAIDs) and non-pharmacologic treatments like physical therapy, according to a study just released by the Workers Compensation Research Institute (WCRI).

John Ruser, president and CEO of WCRI, said opioid overdose deaths continue to be a top public health priority in the United States. “This report informs policymakers and other stakeholders about changes in the way that injured workers are being treated for pain in workers’ compensation systems, and provides information to monitor the impacts of ongoing policy changes.”

The study, Interstate Variations in Dispensing of Opioids, 5th Edition, examines interstate variations and trends in the prescribing patterns of opioids, pain medications, and other pain treatments across 27 state workers’ compensation systems covering data from October 2011 through March 2018. The following are among the study’s findings:

• Despite declines, opioid prescribing continues to be prevalent among nonsurgical claims with more than seven days of lost time and there remains substantial interstate variation in opioid dispensing.

• While significantly fewer injured workers received opioid prescriptions paid under workers’ compensation, the increase in those receiving non-opioid pain medications was smaller and did not fully offset the significant reductions in opioid dispensing. Therefore, at the end of the study period, fewer injured workers received pain medication prescriptions and prescriptions in general that were paid under workers’ compensation.

• Throughout the study period, a similar proportion of injured workers in most states received some form of pain treatment, either pain medications or non-pharmacologic pain treatment, throughout the study period, but there was a shift in treatment patterns from prescribing pain medications (with or without non-pharmacologic treatments) to providing non-pharmacologic pain treatments.

• Concomitant exposure to opioids and anticonvulsants has been shown to increase the odds of opioid overdose deaths. In the most recent time period studied, opioids and anticonvulsants (Neurontin® and Lyrica®) were concurrently dispensed in 4–6 percent of claims with opioids in eight study states.

• In states where a higher proportion of claims had a first opioid prescription exceeding 7 or 14 days of supply, the chronic opioid use rate was also higher, which means injured workers were more likely to receive at least a 60-day supply of opioids over any 90-day period.

This study examined over 575,000 nonsurgical claims with more than seven days of lost time that received at least one prescription paid under workers’ compensation in 27 states. The 27 states in the study are Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

To learn more about this study, visit WCRI’s website at https://www.wcrinet.org/reports/interstate-variations-in-dispensing-of-opioids-5th-edition. The study was authored by Vennela Thumula, Dongchun Wang, and Te-Chun Liu.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.