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Washington’s smart policy on opioids

The state of Washington is a monopolistic workers comp state; unless an employer is large enough to be self-insured, it has to buy workers comp insurance from the state itself.
As a monopolistic state, the regulators have even more power than in the highly regulated but non-monopolistic states. One area of particular interest is how the state deals with the WC drug formulary, which specifically excludes Actiq and Lyrica.
Washington’s Health Dept. just released new guidelines on the use of narcotic opioids; the guidelines, their development process, and the impact of same should be watched carefully by regulators, insurers, managed care firms and most of all prescribing physicians.

Focussed on chronic pain treatment, the guidelines call for a maximum daily dosage of 120 mg. of morphine or its equivalent
The guidelines were inspired in part by research indicating five injured workers were dying each year from overdoses of narcotics in the state. The state has made several tools available via the web for physicians looking to assess their prescriptions’ compliance with the new guidelines.
The use of high cost and high impact narcotics continues to plague the workers comp world. Costs are rapidly increasing, and the impact of these drugs on claimants can be devastating. The US death rate from opioids is higher than the death rate from cocaine and heroin.
What does this mean for you?
While Washington’s guidelines will not eliminate inappropriate prescribing, they will certainly affect prescribing patterns, and likely lead many physicians to more carefully consider the drugs they prescribe.

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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