Finance chiefs at companies with facilities in New York and Louisiana now have a clear indication of how to cut workers’ compensation costs and better manage workplace injuries: find ways to cut down on the prescribing and use of narcotics to kill pain. In those two states, the amount of narcotics used by an average injured worker is “striking,” a new study by the Workers Compensation Research Institute (WCRI) finds.
In New York and Louisiana, the average injured worker received more than 3,600 milligrams of morphine-equivalent narcotics per claim (double the number in the typical state), according to the study, “Interstate Variations in Use of Narcotics 2nd Edition.”
That amount of drugs is equivalent to an injured worker taking a 5-milligram Vicodin® tablet every four hours for four months continuously, or a 120-milligram morphine equivalent daily dose for an entire month, according to a WCRI statement on the study.
Other research suggests that the biggest potential for abuse of the workers comp system and the highest potential costs for employers stem from long-term use of prescription drugs by injured workers. Over the first year or two of a claim, prescription drugs may represent just 2 to 3 percent of all workers’ comp costs, according to one estimate. But for claims stretching out six or eight years, prescription drugs can represent 15 to 20 percent of all costs.
Opioids in particular can produce added costs and loss of productivity. They also put workers at higher risk of prescription drug abuse and accidental death, experts say.
In the WCRI study, the amount of narcotics per claim was also higher than normal in Pennsylvania and Oklahoma (32–48 percent higher than the typical state). The situation in Michigan appears to have changed dramatically: While the state was among the states with a lower usage of narcotics per claim compared with the typical state in 2008-2010, it had the highest amount of narcotics per claim among the Midwest states in the current study.
Narcotics are frequently used in the workers’ compensation system overall, according to the study. In 2010-2012, about 65 to 85 percent of injured workers with pain medications received narcotics for pain relief in most states. A slightly higher proportion of injured workers with pain medications in Arkansas (88 percent) and Louisiana (87 percent) received narcotics.
WCRI examined interstate variations and trends in the use of narcotics and prescribing patterns of pain medications in the workers’ compensation system across 25 states. The study is based on about 264,000 workers’ comp claims and 1.5 million prescriptions associated with those claims. The claims represent injuries arising from October 1, 2007, to September 30, 2010, with prescriptions filled up to March 31, 2012. The underlying data reflect an average of 24 months of experience.
These states included in the study are Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.