Senior researcher Dr. Dongchun Wang’s presentation delved into the details, looking at data from 300,000+ non-surgical lost time claims, with scripts filled thru March 2011. I emphasize non-surgical, as its entirely understandable that a patient just out of surgery would get some opioids to help them deal with post-surgical pain for a few days.
Takeaways…
- Why are so many non-surgical claims getting opioids? With rare exceptions, opioids are NOT indicated for these types of claims. Who’s prescribing these drugs and why is this allowed?
- Building off yesterday’s discussion of variation in prescribing patterns, we’ve seen huge variations in prescribing patterns – dosage, duration, long-term vs short term usage.
- The volume of opioids received per claim varied by a factor of four among the study states – lowest in Iowa, and highest in NY (on a morphine equivalent basis)
- In four states, more than ten percent of claimants who received opioids were still getting scripts six months later – and remember, these are non-surgical cases. While only 3% of AZ claimants were using drugs for more than six months, 17% of those in LA were…
- 24 percent of drug claimants were tested in 2009/2011; a big improvement over the 14 percent from the previous two-year period – but still abysmal. (disclosure – Millennium Labs, a drug testing firm, is a consulting client)
- As bad as that rate was, it was better than the use of psychological evaluations which should be done prior to prescribing – only 7 percent of claimants had psych evals…
