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Opioids – the IAIABC responds, and others do too…

After failing to approve model language developed by many volunteers working many hours over many months, the IAIABC’s Executive Committee came out with a press release discussing their decision.

First, kudos to the EC for the release. This is a very contentious and highly visible issue, so the release helps explain the decision.  However, the explanation itself has done little to tamp down the furor over the non-decision.

Second, the entire workers comp world had this as a no-brainer; of COURSE the IAIABC would approve model language; opioids are widely recognized as one of if not the biggest problems in workers’ compensation, the model language development process had been going on for over a year, and there was no real indication from the EC that they had significant problems with the language.  As the trade group for WC regulators, the IAIABC absolutely would be out front on this.

The guidelines were going to be discussed in a session at Operation Unite’s National Rx Drug Abuse Summit in April, a session that has been cancelled.  They were also going to be reviewed in another session at the same conference; obviously that’s not going to happen either.

And that’s why the Executive Committee’s failure to approve the model language was such a shocker.

The press release did say the EC wants the language re-done;

“adopting model legislation and regulation on opioid use could be interpreted as too narrow and restrictive for jurisdictions. The Executive Committee was concerned the models could unintentionally create conflict in jurisdictions that may be already taking steps to initiate regulations for appropriate guidelines. However, they contain valuable information, and as such the Executive Committee is asking that the issues addressed in the drafts be re-framed to offer policy considerations rather than a single policy response.”

Michael Gavin, who worked long and hard on the guidelines wrote at PRIUM’s Evidence-based blog that the EC’s failure to approve the model language:

is absolute nonsense and an abject failure on the part of this organization.

I cannot understand how “model” legislation would in any way harm a jurisdiction.  Can the elected leaders in any one of our great states not resist the vast power and influence of the IAIABC?  Is there no way that a suggested regulatory framework could be changed to the suit the needs of a specific jurisdiction?  Does the IAIABC hold such incredible sway over state legislatures throughout the land that the mere mention of controlling opioid abuse through model laws would cause political, cultural, and clinical mayhem?

Normally a reserved and diplomatic individual, Michael is saying what many others are thinking.  I’m guessing some members of the EC may have been surprised by the reaction to their decision.  IF they were, they shouldn’t have been.  This was, and still is, an opportunity for the IAIABC to lead from the front, to use its considerable influence to begin to stop the dying, the ruining of individual lives and families, the outrageous expense, the societal damage.

If the IAIABC moves quickly to publish comprehensive, specific, and definitive language, the damage – to the organization and its reputation – will be minimized. Call it model language, an example, a guideline, a framework; whatever.  If the process is extended and the result in any way nebulous, ambiguous, vague, or equivocal the damage done will be extensive and lasting.

The IAIABC has done much good work over its long history. The people who work at their offices in Madison, Wisconsin are dedicated, positive, very knowledgeable, and committed.  I’ve met and worked with several members of the EC and been impressed; these are individuals who’ve spent their professional lives working in a highly politicized environment yet succeeding more often than not in making progress on key issues.

To the EC members who blocked approval, I beg of you – get this done, and get it done now.



2 thoughts on “Opioids – the IAIABC responds, and others do too…”

  1. well done to push this so hard. There action would give real hope to getting multiple lgisaltures to act and otherwise, progress will continue at the usual snails pace of worker’s compensation reform. this type of legislation is so obvilously a win/win for employers and employees, it is hard to understand how they missed the boat so badly.

  2. I am new to the State of Michigan Workers Compensation Advisory Board, yet have a few questions as to what bodily injuries are MOST involved in the individuals who fall victim to the opiate abuse?? Is it in individuals who lose a limb, or suffer a head injury, or is it for those who suffer a spinal injury? I am very upset that over a year ago here in Michigan the legislation moved to increase the 10 day rule to a 28 day rule in which an injured person now must treat with the company MD or DO for 28 days prior to being able to seek out the care with another doctor of the injured party’s choice! Many times an injured person could have seen a Doctor of Chiropractic and had the issue resolved in a short period of time with low cost, but now with this 28 day wait period, many injured persons are given pharmaceutical medications including opiates to COVER UP the pain, thus contributing to the long term and VERY costly opiate issues that W/C committees are struggling with to solve. I say strike this rediculous 28 day rule, get the injured persons to the appropriate doctor as soon as possible and solve the issues quickly and cost effectively! Chiropractic care has time and again proven effective in many cases, with low costs overall and tremendous patient satisfaction! Is this NOT what we W/C Boards desire?? Why the political fight to lessen a truely proven chiropractic involvement in these cases?? It befuddles me to no end! Do you W/C Boards truely care about effective outcomes? If so, It is high time to give Chiropractic services a second look! It is part of the solution! Curious as to your feedback on my entry here!

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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