WCRI: The overuse of narcotics is a major national public health problem. Medical treatment guidelines recommend that patients who receive ongoing narcotics prescriptions be actively monitored by the physician using urine tests and given psychological evaluations.
However, many physicians who prescribed narcotics to injured workers were not using the recommended tools to monitor use, abuse, and diversion, according to a new study, Interstate Variations in Use of Narcotics, by the Workers Compensation Research Institute (WCRI).
WCRI’s study also identified certain states where patients who began treatment with narcotics were more likely to end up using narcotics on a longer-term basis—California, Louisiana, Massachusetts, New York, North Carolina, Pennsylvania, and Texas.
The study is based on nonsurgical workers’ compensation claims that had more than seven days of lost time and received prescription pain medications. The data cover injuries in 2006 and prescriptions filled through March 2008. The reader should be cautioned that the data, based on an average 24 months of experience, is not necessarily sufficient to capture the full utilization of narcotics.
The states included in the study are: California, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, Tennessee, Texas, and Wisconsin.
- The amount of narcotics per claim was the highest in Louisiana, Massachusetts, New York, and Pennsylvania among the 17 states studied.
- In the other 13 states, there were large differences in the amount of narcotics received by injured workers.
- A higher than typical percentage of claims that received narcotics may signal overuse of narcotics for some states.
- The proportion of nonsurgical cases with narcotics that were identified as longer-term users of narcotics was substantially higher than typical in California, Louisiana, Massachusetts, New York, North Carolina, Pennsylvania, and Texas.
- Few longer-term users of narcotics received the recommended services for monitoring, contrary to medical guideline recommendations.
Interstate Variations in Use of Narcotics. Dongchun Wang, Kathryn Mueller, Dean Hashimoto, with the assistance of Jie Chen. July 2011. WC-11-01.
The complete report is available here (purchase required).