OH: Number of Injured Workers Dependent on Opioids has Decreased

Liz Carey

Columbus, OH (WorkersCompensation.com) – For six straight years, the number of injured workers in Ohio who are dependent on opioids has fallen.

According to Nick Trego, Pharmacy Director for the Ohio Bureau of Workers’ Compensation (BWC), the number of injured workers who met or exceeded the threshold of being clinically dependent on opioids fell to 3,315 at the end of 2017, down 19 percent from 2016 and down 59 percent since 2011.

Speaking to the BWC’s medical services and safety committee, Trego said that translated 4,714 fewer injured workers at risk for opioid addiction, overdose and death.

“These falling numbers are the direct result of our efforts to improve our protocols, more closely monitor our opioid population and encourage best practices from our prescribers,” he said. “But we also have to give credit to the growing awareness of the opioid epidemic and efforts by the health care community, government and others to do something about it.”

In an interview with WorkersCompensation.com, Trego said the two biggest factors in decreasing those numbers were the opioid prescribing rule and the implementation of a drug formulary.

The BWC instituted changes to its policies when it was discovered that more than 8,000 injured workers in Ohio were defined as “clinically dependent” on drugs. Those changes included the creation of a pharmacy and therapeutics committee, a panel of physicians and pharmacists that creates and reviews medication policy; and the development of a formulary and instituting the 2016 Opioid Rule that among other things could decertify prescribers accountable if they didn’t follow best practices.

No prescribers have been decertified yet, Trego said, but the process is a long one and one that the pharmacy department of BWC would implement in connection with other departments of the BWC.

Trego told the committee his department’s opioid drug costs fell $24 million in 2017, with total drug costs falling $86 million.

According to the US Bureau of Labor Statistics, drug overdoses are the fastest growing cause of death in the workplace. Of the 5,190 workplace fatalities in 2016, overdoses made up only 4 percent, but the percentage of drug overdose fatalities in the workplace increased by 30 percent over the previous year.

Drugs in the workplace mean not only costs to a business through chronic absenteeism, lateness, turnover, lost productivity and crime, but also through the pocketbook. Health care costs for substance abuse alone may amount to $600 billion in losses a year, according to the National Institute on Drug Abuse.

Opioids alone are thought to have killed 42,000 in 2016. According to the Center for Disease Control, 40 percent of those deaths involved prescription opioids.

In Ohio, out of the 4,050 overdose deaths in 2016, 83 percent were from opioids, and 564 of them, or nearly 14 percent, were from prescription opioids. Trego said it was unclear how many of those were through BWC.

Trego said the BWC also works with employers to help them understand what programs are available to their employees, and that BWC will pay for any employees who may need to go through detox for opioid addiction.

“Employers have a huge opportunity to help their employees to overcome these issues,” Trego said. “Obviously, they see them on a day-to-day basis and can help them get into the program… It’s tough for someone to volunteer ‘I’m dependent on opioids and I want to get off of them’ and I think it takes the individual’s attorney, their employer, their family coming together with them to provide a support group to help them get through it.”

So far, fewer than 10 injured employees have gone through the BWC’s detox program, Trego said.

Trego told the committee he expects BWC’s opioid numbers to continue to fall.

“Weaning a dependent person off opioids, or at least to safe levels, is a long, deliberate process requiring cooperation from the injured worker, health care providers and the workers’ support network,” Trego said. “We’re just one part of that equation, but we’re committed to it.”