Gary M Franklin1,2,3,4, Mark Mercier1, Jaymie Mai1, Doug Tuman1, Deborah Fulton-Kehoe2, Thomas Wickizer5, Jeanne M Sears3. 1. Washington State Department of Labor and Industries, Olympia, Washington. 2. Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington. 3. Department of Health Services, University of Washington, Seattle, Washington. 4. Department of Neurology, University of Washington, Seattle, Washington. 5. Division of Health Services Management and Policy, The Ohio State University College of Public Health, Columbus, Ohio.
Abstract
BACKGROUND: Evidence has associated opioid use initiated early in a workers' compensation claim with subsequent disability. In 2013, the Washington State Department of Labor and Industries (DLI) implemented procedures based on new regulations that require improvement in pain and function to approve opioids beyond the acute pain period. METHODS: We measured opioid prescriptions between 6 and 12 weeks following injury, an indicator of persistent opioid use. Actuarial data for the association of any opioid use versus no opioid use with development of lost time payments are reported. RESULTS: Prior authorization with hard stops led to a sustained drop in persistent opioid use, from nearly 5% in 2013 to less than 1% in 2017. This reduction was also associated with reversal of the increased lost work time patterns seen from 1999 to 2010. CONCLUSIONS: Prior authorization targeted at preventing transition to chronic opioid use can prevent and reverse adverse time loss development that has occurred on a population basis concomitant with the opioid epidemic.
BACKGROUND: Evidence has associated opioid use initiated early in a workers' compensation claim with subsequent disability. In 2013, the Washington State Department of Labor and Industries (DLI) implemented procedures based on new regulations that require improvement in pain and function to approve opioids beyond the acute pain period. METHODS: We measured opioid prescriptions between 6 and 12 weeks following injury, an indicator of persistent opioid use. Actuarial data for the association of any opioid use versus no opioid use with development of lost time payments are reported. RESULTS: Prior authorization with hard stops led to a sustained drop in persistent opioid use, from nearly 5% in 2013 to less than 1% in 2017. This reduction was also associated with reversal of the increased lost work time patterns seen from 1999 to 2010. CONCLUSIONS: Prior authorization targeted at preventing transition to chronic opioid use can prevent and reverse adverse time loss development that has occurred on a population basis concomitant with the opioid epidemic.
Authors: Vi T Le; Deborah Fulton-Kehoe; Jeanne M Sears; Esi W Nkyekyer; Dawn M Ehde; Morgan Young; Gary M Franklin Journal: J Occup Environ Med Date: 2022-02-22 Impact factor: 2.306
Authors: John R Haight; Jeanne M Sears; Deborah Fulton-Kehoe; Thomas M Wickizer; Gary M Franklin Journal: J Occup Environ Med Date: 2020-07 Impact factor: 2.162
Authors: Jeanne M Sears; John R Haight; Deborah Fulton-Kehoe; Thomas M Wickizer; Jaymie Mai; Gary M Franklin Journal: Health Serv Res Date: 2020-10-04 Impact factor: 3.734