Study: Narcotic Use in Workers’ Compensation Claims

December 30, 2009

When it comes to workers’ compensation prescription costs, narcotic drugs account for nearly one quarter of the cost, according to a new industry study. Despite the serious risks associated with narcotics usage, some physicians prescribe narcotics for minor injuries, such as sprained ankles. This practice, according to the Federal Drug Administration (FDA), can be dangerous.

A newly released study by the NCCI study examines the use and prescribing patterns of this controversial category of drugs in workers compensation. The study found that:

  • Narcotics account for nearly one quarter of all workers compensation Rx costs. This share of cost has been relatively constant since service year 2000.
  • The narcotics share of drug costs increases as claims age. This is due to the use of higher-cost narcotics as claims age.
  • Narcotics costs per claim vary by state with apparent regional differences. Midwestern states tend to be lower-cost states and coastal states tend to be higher cost.
  • Narcotics are used mostly for back injuries in workers compensation
  • Narcotics use early in the life of claims is increasing
  • Narcotics use can persist for many years

Few members of the medical community would object to the use of narcotics to treat severe, chronic, cancer-related pain, but more and more medical providers seem divided over the suitability of narcotics to treat other forms of pain, such as those resulting from the majority of workers compensation injuries.

The Federal Drug Administration (FDA) is currently establishing a new federal program designed to ensure the safe, appropriate use of narcotics. The New York Times discussed this future FDA program designed to control “the prescribing, dispensing and distribution of extended-release [narcotics].” One aim of the future program would be to ensure that only physicians who are properly trained in the safe use of narcotics can prescribe them.

Some studies suggest there is a growing consensus that [narcotic] therapy is appropriate for chronic noncancer pain. One article notes that, in at least one state, diagnoses of “chronic pain” or “failed back syndrome,” “virtually guarantee that the claim involves over prescription [of narcotics] because these are the diagnoses used to justify the use of narcotics.” Another says that overuse of narcotics has “shown adverse effects on the overall well-being and treatment of injured parties.”

Heavy narcotics use for workers compensation injuries is also related to substance-abuse treatments, the NCCI report says.

To read the full NCCI study visit: https://www.ncci.com/documents/Narcotics_in_WC_1209.pdf.

Source: NCCI

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