Longer-Term Use of Opioids With opioid misuse a top public health problem in the United States, this report examined longer-term use of narcotics in 21 states and how often recommended treatment guidelines for monitoring injured workers with longer-term use were followed by physicians. The monitoring included services, such as drug testing and psychological evaluations, which can help prevent opioid misuse by injured workers that could result in overdose deaths, addiction, and diversion. However, the study found relatively low compliance with medical treatment guidelines in most states. The information provided will help public officials identify means to strengthen the design or implementation of public policies related to narcotic use, and help payors target efforts to better manage the use of narcotics while providing appropriate care to injured workers and reducing unnecessary risks to patients and unnecessary costs to employers. Among the study’s finding: • Among 2009/2011 claims with longer-term use of narcotics, 18-30 percent received drug testing in most states studied, with the 21-state median at 24 percent. Over the study period, the percentage of workers with longer-term use of narcotics who received at least one drug testing increased from 14 to 24 percent in the median state. However, the use of the service was still lower than recommended by treatment guidelines. The use of psychological evaluation and treatment services continued to be low. Only 4–7 percent of the injured workers with longer-term narcotic use received these services in the median state. Even in the state with highest use of these services, only 1 in 4 injured workers with longer-term narcotic use had psychological evaluation and 1 in 6 received psychological treatment. Little change was seen in the frequency of use of these services.
The study is based on nearly 300,000 workers’ compensation claims and 1.1 million prescriptions associated...