California Workers’ Compensation Rating Bureau Issues Report on Opioids

April 24, 2019

The use of opioids has significantly and continuously declined in the California workers’ compensation system since 2012, a trend that may be leading to a shift in the patterns of medical treatments for California’s injured workers as well as more utilization of alternative measures, according to a report from the Workers’ Compensation Insurance Rating Bureau of California.

The WCIRB on Wednesday released its “Early Indicators of High-Risk Opioid Use and Potential Alternative Treatments” report, which study compares characteristics of claims involving high levels of opioid use to claims with similar injury mix and injured worker age that involved only a lower dose of opioids.

Findings include:

  • Roughly 2.5 percent of all Accident Year 2013 claims with any opioid prescription involved high-risk opioid use within 12 months of the date of the injury compared with 1.4 percent of Accident Year 2016 claims.
  • High-risk opioid use claims incurred significantly higher medical and indemnity costs than similar lower-dose use claims, and they tended to remain open longer.
  • High-risk opioid use claims were much more likely to involve permanent disability benefits than similar lower-dose claims.
  • During the first six months of treatment, the number of opioid prescriptions per AY2013 claim was 50 percent lower on lower-dose use claims compared to the similar high-risk claims, contributing to 50 percent lower total drug payments per claim.
  • Early indicators of high-risk opioid use include obtaining similar opioids from multiple dispensers, having overlapping opioid prescriptions, using extended-release/long-acting opioids and concurrently using opioids and benzodiazepines.
  • Physical therapy, acupuncture and chiropractic services – as well as nonsteroidal anti-inflammatory drugs and non-narcotics – were used significantly more on similar lower-dose use claims than on high-risk use claims.

The full report is available on the WCIRB website.

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