Five Strategic Things States Can Do to Help Fight the Opioid Crisis

| | Technology & Integration, Utilization Review

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Jaelene Article from July 2017
At UR Nation, we believe states can take very specific steps to fight the war on opioid addiction. So far, the most effective actions states can take are implementing prescription drug formularies, requiring participation in a prescription drug monitoring program (PDMP), and setting script limits for doctors prescribing opioids – such as a maximum 7-day supply. But those are by no means the only steps a state can take. Below are five things states can do, and some are already doing them, to help fight the opioid crisis.

 

  1. Require Mandatory Education for Prescribers

A state’s medical board could require mandatory education for all prescribers. We are not suggesting anything invasive or burdensome – perhaps just a 2-hour online class on the dangers of opioid prescribing.  Recently, FDA Commissioner Scott Gottlieb spoke at an FDA meeting on abuse-deterrent opioids and said the FDA is considering mandatory opioid education for prescribers. Mr. Gottlieb’s prepared statement was part of the FDA’s meeting on Data and Methods for Evaluating the Impact of Opioid Formulations with Properties Designed to Deter Abuse in the Post Market Setting. For prescribers who may feel UR Nation is picking on you, don’t worry, we’ve got mandatory education for applicant attorneys as well. See below.

  1. Beef Up the Initial Opioid Script Limit Like NY

Most script limits, such as in Louisiana and Utah, are for 7-day supplies. In other words, a prescriber cannot write a script for a 30 or 60 day supply of opioids. New Jersey Gov. Chris Christie signed SB 3 into law, which limits initial prescribing of opioids for acute pain to a 5-day supply. The bill also requires prescribers to document a patient’s history of opioid use before writing the initial prescription and also document the patient’s response to non-opioid therapies, including alternate drugs and non-drug treatments. The bill also mandates opioid education for prescribers. The bill does not appear to be specific to workers’ comp, but Brian Allen, VP Government Affairs at Optum, said SB 3 should benefit the workers’ comp system where injured workers have been taking opioids long term.

  1. Have Employers Educate Employees on the Dangers of Opioids, as in Pennsylvania

The Pennsylvania Bureau of Workers’ Compensation offered a free webinar on May 16 to employers to help combat opioid addiction in the workplace. Readers may follow the link and call the training number or use the listed email address. The topics included an overview of opioids, which drugs are most commonly prescribed, how addiction begins, signs of addiction, and what employers and physicians can do to help those affected. Online materials included a slide presentation, fact sheets, curriculum outline and a quiz that can be used in workplace training. We believe there’s no reason why an employer cannot provide an employee, shortly after an industrial accident, a flyer about the dangers of opioid addiction.

  1. Require Applicant Attorneys to Train on the Dangers of Opioid Addiction, as in Massachusetts’ Pilot Program

The Massachusetts Bar Association announced that applicant attorneys will be offered free training on the state’s new two-year anti-opioid pilot program. The purpose is to help applicant attorneys identify clients who might be suitable for the program. Through the program, Massachusetts will assign care coordinators to opioid using workers whose cases have settled. Once employers stop paying for opioids, if workers have become addicted, some will turn to illegal drug use. Specifically, the training will cover (1) the opioid epidemic’s impact on MA, (2) the types of cases suitable for the program, (3) how to use the state mandated forms related to the program, and (4) the new fast track court proceeding rules associated with the program. Applicant attorneys are in an ideal situation to counsel their clients on the dangers of opioid addiction.

  1. Have Workers’ Comp Carriers Writing Business in State Tell Injured Workers to Ask About a State’s PDMP, as Employers Mutual Does in Maine

Employers Mutual Insurance Co. released a statement telling injured workers taking certain medications to speak to their prescribing physician about the prescription drug monitoring program (PDMP). This is because prescribers are required to check Maine’s PDMP before writing a prescription for opioids or benzodiazepines (like Xanax, Klonopin, and Valium). The law also prohibits opioid prescriptions that are beyond the equivalent of 100 mg of morphine for new patients. It also limits existing patients to 300 mg of morphine equivalent. However, the 300 mg cap dropped to 100 mg in July of 2017. Lastly, the bill prohibits opioid prescriptions exceeding seven days for acute pain and 30 days for chronic pain.

We believe that these creative steps do not require significant amounts of new spending and offer a common sense approach in the war against opioid addiction.

Jaelene Fayhee

Jaelene Fayhee

Jaelene Fayhee, AVP, Client Solutions for UniMed Direct, is a regulatory expert who works hand-in-hand with clients and the technology department to deliver technology and medical solutions to clients. Jaelene is focused on using technology to ensure compliance with current and upcoming regulatory requirements and delivering prompt and appropriate decisions to expedite medical decisions for injured workers.