April 18, 2018
New studies on opioids show ineffectiveness, high cost
Almost daily, reports of opioid misuse and overdose make the news as the opioid crisis continues to effect more lives. In the past few months, studies and research have provided new information about the effectiveness of opioids and the rising toll of the opioid epidemic. For the first time since 1963, the average life expectancy in the U.S. has dropped two years in a row , due in large part to increases in opioid overdose.
A government-funded study has shown that after a year of treatment, opioids weren’t any better than common painkillers . The study measured improving pain related to daily functioning, such as ability to sleep and work. In fact, opioids were slightly worse at controlling pain intensity but had more side effects. While opioids are good at treating acute pain, they are less effective for chronic pain.
A Workers’ Compensation Research Institute study has linked long-term opioid use with later return to work for injured workers . For work-related, nonsurgical, lower-back injuries, long-term opioid prescriptions tripled time away from work in comparison to claims without a prescription.
Other research has shown a 30 percent increase in emergency room visits nationwide due to opioid overdose. Within the Midwest, there was a 70 percent rise. The economic cost of the opioid crisis has exceeded $1 trillion since 2001 . Much of the cost comes from lost wages, lost productivity and health care costs. This doesn’t account for the emotional costs to individuals with opioid addictions, as well as their families and loved ones.
SFM’s commitment to reducing opioid use
In 2014, SFM determined that the increasing long-term opioid use by injured workers was a vital public health issue. SFM began reviewing older claims with long-term opioid use in high doses and recommending alternatives to opioids for newer claims. To aid in this, SFM hired Gail Pravatiner, an experienced drug review nurse. Pravatiner reviews claims, communicates with physicians and injured workers and manages medications for high-risk claimants.
Long-term opioid treatment parameters support Pravatiner in her efforts. In July 2015, Minnesota Department of Labor and Industry published treatment parameters addressing opioid use long term. In March 2016, the Centers for Disease Control and Prevention published guidelines that supported the minimum effective dose and assessed the efficacy of treatment plans that involve opioids.
Both the treatment parameters and CDC guidelines determined that physicians should recommend non-opioid treatment first. If opioids are prescribed, there should be an evaluation of the risk of harm or misuse. When necessary, they should yield not only a substantial improvement in pain but also an increase in function.
After tracking opioid use from July 2015 to July 2017, SFM found that 66 percent of cases with high opioid use either have decreased the dosage or have stopped using opioids completely. Pravatiner believes that this is due in part to the increasing public awareness of the opioid epidemic and to the education she and SFM provide to injured workers and prescribers.