Study Calls Into Question Use of Narcotics in California Workers’ Comp Claims

A relatively small percentage of medical providers are responsible for writing narcotic prescriptions in California workers’ compensation claims, according to a new report by the California Workers’ Compensation Institute. According to CWCI’s recent study, “Prescribing Patterns of Schedule II Opoids in California Workers’ Compensation,” nearly half of the prescriptions are for minor back injury claims.

The report specifically looked at the use of Schedule II opoids, which are major narcotics such as oxycodone, fentanyl, mortphone and methadone. These drugs have limited FDA-approved medical uses and carry a higher potential for addiction and abuse, CWCI said.

The report indicates that 3 percent of the prescribing physicians accounted for 55 percent of all Schedule II prescriptions, 62 percent of all morphine equivalents and 65 percent of all associated payments in the study sample. Furthermore, the top 10 percent of injured workers receiving Schedule II morphine equivalents obtained their prescriptions from an average of 3.3 different physicians, compared to an average of 1.9 doctors for all claims.

The average levels of morphine equivalents per claim are consistent with an increased risk for overdose and addiction, CWCI said.

The report calls into the question of Schedule II opioid prescriptions for minor back injury claims, because the American College of Occupational and Environmental

Medicine describes the use of such prescriptions as “typically not useful in the sub-acute and chronic phases.”

“These results underscore the need for additional research, investigation and serious consideration of statutory and/or regulatory policy enforcement and reform,” CWCI concluded.

A recent report by the National Center on Addiction and Substance Abuse at Columbia University found that 15.1 million Americans — more than 6 percent of this country’s adult population — admit to abusing prescription drugs. Furthermore, the study noted that between 1998 and 2008, hospitals nationwide reported a 400 percent increase in admissions related to prescription narcotic abuse and a 200 percent increase in prescription narcotic deaths. While the use of all prescription medications rose 61 percent during that time, the use of Schedule II opioids increased by 380 percent.

To view the California workers’ compensation report on Schedule II opoids, go the research section on CWCI’s Web site.