To combat the growing epidemic of opioid abuse, the Center for Disease Control issued guidelines aimed at limiting the prescription of opioids in ways that might lead to ongoing addiction. Studies have shown that approximately 75% of new heroin users stated that they started their addiction with prescription opioids. Via various methods; obtained themselves with a prescription or from someone else. State governments and the insurance industry have been heavily involved in trying to reduce opioid prescriptions as a way of combating the epidemic, while also aiming to lower the costs of workers compensation claims which can increase exponentially when pain leads to addiction.
Now studies are being released on the effectiveness of the new Center for Disease Control Guidelines. Focusing on several key measureable aspects of those guidelines, studies have shown significant decreases in opioid prescriptions.
Hopefully these results can continue this trend forward of decreasing opioid prescriptions and opioid addictions. Prescriptions written per hundred people and the amount prescribed per person have decreased nationally in the past few years, but are still significantly higher than they were twenty years ago.
One particular study commissioned by Mitchell Pharmacy Solutions looked at over eight hundred thousand workers’ compensation claims in the past six years. It measured changes before the issuance of the Center for Disease Control Guidelines in March of 2016 and changes since that date and tracked five measurements for statistically significant changes.
The first measurement tracked the length of the first opioid prescription in these workers’ compensation claims. The CDC guidelines suggested doctors avoid issuing prescriptions for longer than seven days when first prescribing opioids. The study found that prior to the CDC guidelines, more than thirty percent of the first prescription for opioids included a supply for more than seven days. After the guidelines, this number dropped to twenty three percent. However, the study also found a sharp drop in the number of prescriptions for a three day supply or less with a massive spike in prescriptions written for a three to seven day supply.
The second and third measurements looked at short release opioids versus long release opioids and the amount of effective doses. The study found small but significant decreases in the prescription of long-acting opioids issued as part of the first prescription for opioid painkillers. The claims also demonstrated a significant decrease in the amount of doses prescribed. Opioid prescriptions are measured for strength in terms of morphine equivalents. After issuance of the CDC guidelines, the amount of prescriptions written for less than fifty morphine milligram equivalents increased to almost 70% of the total opioid prescriptions written.
The final two measurements focused on acute pain prescriptions and concurrent prescriptions. While the CDC had recommended avoiding prescribing long-acting opioids for acute pain, the study did not see any measurable difference in prescriptions fitting this category. The CDC also recommended against concurrent prescription of benzodiazepines (commonly prescribed for anxiety disorders) with opioids, as it increases the likelihood of overdose deaths. After the issuance of the CDC guidelines, the study found concurrent prescriptions for opioids and benzodiazepines had been cut in half.
The available evidence shows that these changes are working. Brian Chance, VP of Claims and Services at ECBM says, "The effectiveness of these changes should lower the costs of workers’ compensation claims... and decrease the likeliness of injured workers facing difficult addictions as a result of injuries suffered in the course of their employment." Employers should stay alert and make sure their programs are following best practices to keep their own workers’ compensation low while also maximizing the benefit to their employees.