Ohio, Indiana Struggle with Impact of Opioids on Injured Workers
Editor’s Note: This is part of a team report on opioid use by injured workers. For the national story read: Opioid Epidemic Plagues Workers’ Comp
In the Midwest the multitude of jobs in the automotive and agriculture industries highlights the importance of the working American and the need for workplace safety. But the area’s numerous industrial type jobs may be lending themselves to the opioid abuse problem.
Ohio
Ohio has been battling a wide-spread prescription drug abuse problem for several years and as recently as April 29, Attorney General Mike DeWine announced a nearly 22 year sentence for the owner of a Chillicothe pain clinic that operated as a “pill mill.”
“Prescription drug abuse is a very serious problem in Ohio, and we will aggressively investigate any medical facility that shows signs of suspected drug diversion,” DeWine said in announcing the sentence.
Ohio’s workers’ compensation fund, the Bureau of Workers’ Compensation, in 2011 implemented its first-ever drug formulary and in 2012 began centralizing drug-utilization reviews and introduced a pharmacy management program.
Since introducing its formulary in September 2011, it has seen a savings of around $12 million, according to Melissa Vince, a spokesperson for the BWC.
“There was a decrease in the number of narcotics prescribed to injured workers by about 12 percent or 1.1 million doses,” she said. Another 58 percent reduction in muscle relaxant prescriptions occurred from February through April 2012, according to the BWC’s annual report.
The BWC also created a “lock-in program to limit the practice of doctor and pharmacy shopping,” Vince said. “And drug utilization reviews to evaluate the necessity for certain prescription drugs and identify where there may be danger or overuse.”
In order to identify where and if medications are being prescribed that aren’t relevant to the workers’ comp claim, the BWC implemented a system of point of service edits for prescriptions with the goal of making sure prescribed medications are going toward conditions in the claim.
“The purpose is not to take medications that are needed away from injured workers but to ensure that they are right for the condition and that there’s a plan in place. The ultimate goal is to return to work,” Vince said.
Indiana
Indiana lawmakers have passed and Gov. Mike Pence has signed Senate Enrolled Act 246, a measure that targets the operations of so-called “pill mills.”
Indiana Attorney General Greg Zoeller said the bill came out of a study by the Indiana Prescription Drug Abuse Task Force, which looked at the problem of pain-management clinics that dispense addictive controlled substances with little oversight.
“The epidemic of prescription drug abuse is fueled by the irresponsible overprescribing of addictive painkillers to patients which leads to drug dependency, easy access for abuse and accidental overdoses, all with terrible consequences,” Zoeller said in a statement.
Under SEA 246, owners of all clinics that prescribe, dispense or administer controlled substances must hold an Indiana Controlled Substance Registration (CSR) for each facility they own in Indiana.
Registration requires owners to oversee clinic operations the operations in the clinic and ensure that practitioners prescribe in a way that complies with law. The bill also facilitates faster enforcement action against practitioners who overprescribe by the AG’s office and makes it easier for enforcement officers to obtain records for an investigation.
INSPECT, Indiana’s prescription drug monitoring program, was also strengthened by the passage of House Enrolled Act 1465 this year. INSPECT maintains a database of controlled substances dispensed by pharmacies. Through INSPECT, physicians can access the database to verify they are not overprescribing to addicted patients who might be drug-seeking. Under HEA 1465, prescribing physicians may electronically transmit prescriptions for certain controlled substances to pharmacies, to prevent forged prescriptions.