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Opioids in workers comp – spend is down a billion dollars.

More than 20 years ago I posted this:

Oxycontin in WC

Where are we today?

After a horrific spike in opioid prescribing for workers’ comp, the industry has done a remarkable job reducing unnecessary and inappropriate opioid usage.

Well, except for the Federal Office of Workers’ Compensation Programs, which was way too late to take action.

Leaving OWCP aside (if only we could), here’s a few statistics:

Our annual Survey of Prescription Drug Management has tracked opioid prescriptions for more than a decade.

  • The 2021 Survey showed a 12.5% drop in opioid spend over the previous year.
  • Opioids represented 13.4% of all respondents’ pharmacy spend, the lowest figure in the history of this survey.
  • A decade ago, opioids accounted for 29.4% of drug spend.
  • And, a decade ago drug spend was MUCH higher than it is today.

Net – workers’ comp has reduced opioid spend by roughly a billion dollars over the last decade.

What does this mean for you?

Thousands of lives saved, families preserved, moms and dads alive, kids not orphaned, addictions avoided.

Thanks to all who have done this – you are treasured.

11 thoughts on “Opioids in workers comp – spend is down a billion dollars.”

  1. Joe, this is one accomplishment of which the WC community can justly be proud. I chose to believe money was not the only, or even primary reason we worked the issue as hard as we did.

  2. Why do you think that is? Can it be due to so many new DME portable ultrasound devices. or Electrical Impulse devices?

    1. Hi Maria – highly doubtful.

      There is very little research supporting the efficacy of those devices, and recent robust research indicating they have little curative or mitigating impact.

      If you have other information please share.

      Rather, as regular readers will recall, this is due to long and intensive effort by many to ensure patients get the right meds. You can read past Surveys here.

      be well Joe

      1. Thank you Joe, I am a DME Network Manager and on a daily basis get companies asking me to get them in TPA network so they can have these devices authorized by the Claims Adjusters. Some believe in technology and some don’t. I believe in some of it but not all. What I am not happy about is the amount of money these providers want for the devices, it is abusive. What I don’t understand is how the FDA approves these products as being effective if if they really don’t work. ???

        1. You’re welcome Maria.

          My admittedly non-expert view is the FDA authorizes, approves, and may otherwise categorize devices. There are different standards/criteria for these categories which may or may not require varying levels of documented research to obtain those categories.

          Other readers may know a good deal more.

          regard Joe

  3. We should be proud of this. I believe the drug makers took advantage of physicians that genuinely wanted to help their patient’s reduce their pain. We have done a lot of work educating providers and workers about the dangers of narcotics. A lot has been done, but there is more to do. I’ll be happy when families no longer suffer when a family member has an addiction.

    1. Mary Ann – and thank you for helping to keep the focus on opioid overuse and abuse. It may seem like shouting into the void at times, but it helps – a lot.

      be well Joe

  4. Maria C, many of these devices are approved through what is called the 510(k) process, in which devices must be shown to be “substantially equivalent” to a device already on the market. You can learn more about the process at

    However, here is a key phrase with my emphasis in caps: “A claim of substantial equivalence does not mean the new and predicate devices needs to be identical. FDA first establishes that the new and predicate devices have the same intended use and any differences in technological characteristics do not raise different questions of safety and effectiveness. FDA then determines whether the device is as safe and effective as the predicate device by reviewing the scientific methods used to evaluate differences in technological characteristics and performance data. This performance data CAN INCLUDE CLINICAL DATA and non-clinical bench performance data, including engineering performance testing, sterility, electromagnetic compatibility, software validation, biocompatibility evaluation, among other data.”

    Bottom line is that manufacturers ARE NOT REQUIRED to prove a new device is clinically effective for any specific diagnosis. This process is far different than for medication approvals by the FDA.

    1. Thanks for the insights on this Dr. Ross – much appreciated.

      Maria – is this helpful?

      be well Joe

Comments are closed.

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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