Opioid Prescriptions Among Patients Receiving Workers’ Compensation

Details

• Corporate Authors:
  Michigan State University. College of Human Medicine
• Description:
  In 2016, in response to concerns about increases in opioid addiction and deaths, CDC issued guidelines about the use of opioids for chronic non-cancer related pain. In the United States, prescription rates for opioids peaked in 2012 and decreased 44% by 2020.2 A similar trend was seen in Michigan where the opioid dispensing rate decreased from 100.7 per 100 persons in 2012 to 54.4 per 100 persons in 2020. In 2020, Michigan had the 12th highest opioid dispensing rate in the United States, and in 2019, with 2,385 deaths, the 21st highest rate of drug overdose deaths. In 2019, the number of opioid prescription related overdose deaths in Michigan was 454, which was decreased from 678 in 2016. However, in 2020, opioid overdose deaths in Michigan increased 16.2 %. In 2018, Michigan began to require a provider writing an opioid prescription to obtain a signature on the Start Talking Consent Form; obtain and review a Michigan Automated Prescription System (MAPS) report for any patient before prescribing a controlled substance for a quantity greater than three days; provide follow-up care or referral to another provider to monitor the efficacy of the controlled substance in treating the patient's condition; prescribe no more than a seven day supply of an opioid to patients being treated for acute pain; and discuss the dangers of opioid addiction, how to dispose of an expired, unused controlled substance, Michigan laws involving delivery of a controlled substance, as well as the short term and long-term effects of exposing a fetus to an opioid. In June 2015, specific regulations related to workers' compensation reimbursement for opioids beyond 90 days began to require a written report every 90 days that included: (a) A review and analysis of the relevant prior medical history and MAPS; (b) A summary of conservative care rendered to the worker that focused on increased function and return to work; (c) A statement on why prior or alternative conservative measures were ineffective or contraindicated; (d) A statement that the attending physician has considered the results obtained from appropriate industry accepted screening tools to detect factors that may significantly increase the risk of abuse; (e) A treatment plan every 6 months that includes: (i) Overall treatment goals and functional progress; (ii) Periodic urine drug screens; (iii) An effort to reduce pain through the use of non-opioid medications, alternative non-pharmaceutical strategies, or both; (iv) Consideration of weaning the injured worker from opioid use; and (f) Every six months an opioid treatment agreement signed by the worker/patient and the doctor. To address opioid prescriptions in workers receiving workers' compensation (WC) in Michigan, individuals who received WC for wage replacement (off work seven or more days in a row) or had a work-related amputation in 2016, 2017 or 2018 were matched with the MAPS data for all dispensed and prescribed controlled substances (DEA schedule 2-5 drugs) from 2003 through September 2020. To ensure confidentiality the MAPS contractor performed the data linkage steps and removed all patient-level identifiers from the linked dataset prior to transferring the data back to MSU for analysis. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Narcotics Occupational Health Safety
• Keywords:
  Medical Care Prescription Drugs Surveillance Workers Compensation
• Publisher:
  Michigan State University-College of Human Medicine
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Newsletter
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-4
• Volume:
  33
• Issue:
  1
• NIOSHTIC Number:
  nn:20066665
• Citation:
  Project S.E.N.S.O.R. News 2022 Jan; 33(1):1-4
• Contact Point Address:
  Michigan State University, College of Human Medicine, West Fee Hall, 909 Fee Road, Room 117, East Lansing, MI 48824-1316
• Federal Fiscal Year:
  2022
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Project S.E.N.S.O.R. News
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e913acca398ba394ad2a7affdbce0f0061a34e9bd554c8807cb16978f0863da68975caf86a0dc0196c82267a24574e788bc2885cd60c6554e5ea5dfc842abfce
• Download URL:
  https://stacks.cdc.gov/view/cdc/230947/cdc_230947_DS1.pdf
• File Type:
  [PDF - 349.08 KB ]