Insight, analysis & opinion from Joe Paduda

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Oct
8

This will make you stop and think.

In 2012, the entire US opioid market was $8.34 billion.

Workers’ comp paid about 17% of that bill.

One of every six opioid dollars was spent by the work comp industry. 

That’s a stunning statistic.

Recall that workers’ comp medical expenses account for about 1.5% of total US medical spend.  Sure, there’s a lot of pain in comp – but there’s a lot of pain in non-comp diagnoses as well.  Chronic non-cancer pain, end-of-life pain treatment, cancer-related pain, acute injuries, surgical recovery, dental procedures can all result in opioid prescriptions.

But few group health patients get opioids for non-skeletal back pain.

What does this mean for you?

We’ve accomplished a good deal in reducing inappropriate prescribing of opioids to comp patients.

But we have very, very far to go.  This is NOT the time to rest on our rather meager laurels.

 


6 thoughts on “This will make you stop and think.”

  1. The NPR radio show “On Point” devoted an hour to this topic the other day. It was a very interesting perspective. Unfortunately, it is an addiction that keeps growing. I think you can download the MP3 file if interested.

  2. I bet if you looked at the nation’s total spend on “pain management physicians” and what portion of that WC compromises you would also find a disproportionate ratio. And it’s no secret which physicians are responsible for the majority of long term opioid prescriptions in WC.

  3. My work is advocating for indigent, disabled adults. Many of them were NOT indigent prior to being injured at work. It appears to me that the doctors employed by WC feel that it is their job to avoid any kind of diagnostic procedure (MRI, CT, etc.) that could possibly prove that a severe injury had taken place and instead, they provide addictive drugs which 1. Create a situation which makes the injured person’s credibility more questionable as time goes on. 2. May mask the pain enough for long enough to (they hope) get the employer (and Worker’s Comp) off the hook for the injured person’s care. From what I have observed, this dismissive “care” can frequently cause the injured employee to become mentally ill as well, wherein as ordinary workers and ordinary people they could have handled much higher degree of stress prior to the injury and the system into which they are forced.
    The average person is not emotionally equipped to handle accusations of “malingering” and “drug seeking behavior” which is what happens relatively quickly with the WC ‘patient’ who has been given narcotics for pain.

  4. Joe,

    What I would be more interested in knowing and probably way more telling then spend is the number of doses per year delivered in WC compared to the rest of the industry. Dollars spent is VERY deceiving in this case, as I am sure you are well aware of. Dollars spent really means nothing, what really matters is the number of scripts.

    JC

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Joe Paduda is the principal of Health Strategy Associates

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