An interesting thing happened on the way to the drug store the other day - it turns out that, according to one research group, workers' compensation claimants are least likely to engage in the consumption of illicit drugs compared to other medical sample groups while recovering from an injury.
And this is in contrast to concerns in the industry, as reflected in those expressed at the Insurance Council of Texas workers’ compensation conference last week, where panel members opined that it would be beneficial to upgrade the state’s prescription drug monitoring program to help curb problems with controlled medications in workers’ comp.
The Texas Legislature created the drug monitoring program in 1982 to monitor Schedule II controlled substance prescriptions. The Legislature expanded the program, effective Sept. 1, 2008, to include the monitoring of Schedule III through Schedule V controlled substance prescriptions.
The Texas Department of Public Safety (DPS) operates and maintains the program.
In August, DPS opened a revised program to allow nearly 90,000 health care practitioners quicker access to information on controlled drugs dispensed to patients.
The revised program allows authorized users to obtain information online. Previously, users had to submit a written request and a hard copy was delivered to them by DPS. The new program will allow users to get the information within minutes rather than days.
Prescription drug monitoring programs are expanding around the nation.
In Oklahoma’s system, anyone who dispenses a controlled narcotic must report that information to the monitoring program within five minutes of the drug being delivered to the customer. That information is then available online to other doctors, pharmacists and some regulatory and law enforcement officers.
New York’s new I-STOP (Internet System for Tracking Over-Prescribing Act) program requires pharmacies to update the state's drug database immediately after filling prescriptions for controlled substances. Doctors must register with the database and check it before prescribing a wide range of drugs on the U.S. Drug Enforcement Administration schedules of controlled substances.
In the meantime, an unnamed Texas insurance company requested that national drug-testing laboratory Ameritox screen urine samples from injured workers to determine the rate of illicit drug use. The surprising result is that workers' compensation patients were actually the least likely of various groups to test positive for recreational drugs, such as cocaine, heroin, PCP, amphetamines or marijuana.
Ameritox compared samples from prescription opioid users whose medical bills are paid by Medicaid, Medicare, private health insurance, workers' compensation or out of the patient's own pocket.
Ameritox analyzed results from 2 million urine samples gathered nationally involving approximately 1.5 million patients from July 2010 through June of this year, all of them pain patients who were prescribed medication, and compared results by the type of payer. The company found that Medicaid patients showed that positive results for illicit drugs were highest when the payer was Medicaid (17.1%), followed by "self-pay" patients (14.8%), commercial insurance (9.7%), Medicare (8.9%) and workers' compensation (8.6%).
Ameritox also tested to ensure that the patients were taking the drugs that were prescribed to them and found that the rate of non-usage didn't vary much, ranging from 31% to 34%.
In the meantime, the Texas Division of Workers' Compensation has adopted a closed formulary which went into effect Sept. 1, 2011.
In June, the DWC reported on a study comparing prescriptions for injuries that occurred between September and November 2011 with injuries that occurred during the same months in 2010 and found that under the formulary, prescription drug costs specifically attributed to not-recommended ("N") drugs for 2011 claims were reduced by 75% (approximately $841,000) when compared to 2010.
At least as far as workers' compensation claims go, the issue with both prescription and illicit drugs seems to have a bright place.