Pharmacy Management Aids in Reducing Opioid Use by Ohio Workers

The amount of opioids prescribed to injured Ohio workers has fallen significantly since the state’s insurance fund for injured workers created a pharmacy management program amid concerns about painkiller usage.

Fewer than 4,800 workers have been deemed opiate-dependent after exceeding 9,300 five years ago, John Hanna, the state Bureau of Workers’ Compensation pharmacy program director, told The Columbus Dispatch on Wednesday.

“We had to draw a line in the sand,” Hanna said. “Injured workers do not go back to work when they’re medicated into a stupor. They don’t go back when they’re dead.”

Opioid doses for injured workers have since dropped by more than 40 percent.

The drop is due to education, Hanna said, as well as a closed prescription drug formulary that was included with the pharmacy management program, which was implemented in 2011.

The newspaper said Ohio and Washington are the only states that have a closed formulary, which lists specific drugs and dosages allowable in workers’ compensation cases.

The insurance fund now wants Ohio to become the first state to write opioid prescription guidelines and workers’ compensation rules into the state’s administrative code.

Doctors would create and monitor a treatment plan, as well as document its effectiveness. There would also be guidelines on weaning injured workers off opioids.

One section of the proposed rule focuses on recording “clinically meaningful improvement in function” to justify giving a worker opioids weeks following the injury or surgery.

The proposal is heading to the bureau’s board of directors and to a legislative panel for review.

It’s important not to go too far, said Dr. Kort Gronbach of Mount Carmel Health, a pain-management specialist who serves on the bureau’s pharmacy and therapeutics committee and who supports the proposal.

Gronbach said some doctors are refusing to treat chronic-pain patients with debilitating conditions.

“It’s as sad as I’ve ever seen it,” Gronbach said. “It’s been so vilified that my patients, on a daily basis, come in crying.”