A new bill could help injured PA workers avoid addiction to opioids

Thousands of people are dying every year in Pennsylvania from overdoses due to opioid and prescription drug abuse. According to the Pennsylvania Department of Health, 10 Pennsylvanians are dying every day due to an opioid or heroin overdose. In 2015, more than 3,500 Pennsylvanians died from an overdose of opioid drugs. A report from the Centers for Disease Control and Prevention (CDC) also found that 27 percent of people who abuse prescription pain medications receive them from a prescription from a doctor.

There is no silver bullet to solve this problem. Communities, families, educators, service providers and the government can all play a role in tackling this issue. We in the state Legislature have been diligently working to enact measures to help curb opioid abuse. As vice chair of the House Labor and Industry Committee I have been an ardent supporter of helping our workers at all stages in their professional lives – including when they are out of work due to a workplace-related injury.

A June 2016 study by the Workers’ Compensation Research Institute brought to light the significant overprescribing of drugs in Pennsylvania’s Workers’ Compensation system. The results were stunning. The study found that, of the 25 states reviewed, Pennsylvania had the third-highest amount of opioids prescribed per injured worker, and the second-highest number of opioid pills prescribed per claim in non-surgical cases.

Not only were injured workers in Pennsylvania being prescribed opioids far more often than other states, they were also being given significantly higher dosage amounts – making it all the more likely that they could fall prey to addiction and possible overdose. Our injured workers deserve the best medical treatment possible, but if opioids and other prescription drugs are being administered improperly, then we are, in fact, doing a disservice to the patient.

Medical providers and elected officials across the U.S. have been increasingly turning to treatment guidelines that are based on medical evidence as a way to address the issue of overprescribing.  Nationally, Republican- and Democratic-controlled states have enacted guidelines for prescribing in the Workers’ Compensation system – also known as a drug formulary.

Texas was an early adopter of a Workers’ Compensation drug formulary, and its results show the dramatic impact such legislation can have. In the six months after implementation, non-formulary drugs and the injured workers who received them fell by over 60 percent. Decreases for controlled substances such as Soma, Xanax, and OxyContin were even more significant. Over 70 percent fewer scripts were written for these types of drugs – meaning 70 percent fewer individuals who could potentially abuse these drugs or get addicted to them. The implementation of the drug formulary also saw workers getting back to a healthy and productive life faster, and average lost-time for workers was down 34 percent.

Since Texas, states across the country have been implementing drug formularies for Workers’ Compensation systems. Most recently, Governors Jerry Brown in California and Andrew Cuomo in New York have both recognized the positive impact of such legislation and signed drug formularies into law to limit the overprescribing and help injured workers. 

The Pennsylvania Medical Society recommends the use of guidelines in many instances. In fact, Pennsylvania Gov. Tom Wolf has implemented the use of guidelines in the state’s Medicaid program when it comes to prescribing opioids. Additionally, the governor has created and advocated for the use of guidelines in the following health care areas: emergency department treatment, geriatrics, chronic non-cancer pain management, dental pain, obstetrics and gynecology, and pharmacy.

During a hearing before the state House Labor and Industry Committee, Gov. Wolf’s Department of Labor and Industry representative testified that they support the objectives of House Bill 18 “…to ensure that injured workers receive prescription drugs that are appropriate for their injuries.”  Although there are special interests who will jealously guard their lucrative stakes in our Workers’ Compensation system, this continues to be an issue where there is bipartisan support for solutions.

In many instances, drugs that were once seen as great treatment options for people who were experiencing pain have now created an epidemic of addiction across our country. While legislation alone will not entirely eliminate opioid issues and overprescribing in Workers’ Compensation cases, results from other states show that we can significantly reduce the problem by implementing a drug formulary.

Pennsylvania has already begun introducing guidelines for prescribing in other areas. I am hopeful that we can take the next step and join in the cause by introducing a drug formulary for Workers’ Compensation and thereby protect injured workers from the overprescribing and addiction that is afflicting far too many.

Ryan Mackenzie (R-Lehigh, Berks) is a Republican member of the Pennsylvania House of Representatives.