Study: California Workers Not Weaned Off Opioids Had Much Higher Drug Costs

Injured workers who were not weaned off of opioids had much higher drug costs and higher treatment transaction volumes, according to a report released on Friday by the Workers’ Compensation Insurance Rating Bureau.

The report, Study of Chronic Opioid Use and Weaning in California Workers’ Compensation, uses data from the WCIRB databases of medical transaction records and unit statistical reports to help understand the cost implications of chronic opioid use and the process of weaning injured workers off of opioids in California workers’ comp.

The study also shows that since 2012, claims with opioid prescriptions in the California workers’ comp system have dropped sharply, but opioid prescriptions still reflect a significant portion of all pharmaceutical costs.

The recent decline in opioid use is attributable to both fewer newer claims for which opioids were prescribed and a reduction in opioid use on claims in which there was “chronic” opioid use, according to the study.

Key findings of the report include:

• Claims involving chronic opioid use cost more than nine times in physician services than the average workers’ comp claim.
• Chronic opioid usage builds gradually. The average claim in the study reached the chronic opioid usage threshold in 11 months from the date of injury.
• Nearly half of the study claims demonstrating chronic opioid usage weaned off of opioids completely within 24 months from the date of injury.
• Injured workers who were not weaned off of opioids had much higher drug costs and higher treatment transaction volumes and costs than those who were weaned off of opioids.
• The weaning process typically involved a gradual decrease in opioid prescriptions combined with a mix of alternative non-drug treatments and non-narcotic drugs. While there were no clear patterns of non-drug treatments for injured workers who were weaned off of opioids, the usage of non-opioid pain medications declined significantly less than that of opioids and other drugs.

The complete report is available in the research section of the WCIRB website.