Opioid dependence continues to fall in Ohio’s work comp system


COLUMBUS — The number of opioid-dependent injured workers in the Ohio Bureau of Workers’ Compensation system fell 19 percent in 2017, the sixth consecutive year the numbers have fallen under BWC’s efforts to reduce opioid use and build a model pharmacy program.

BWC Pharmacy Director Nick Trego recently told the agency’s board of directors that the number of injured workers who met or exceeded the threshold of being clinically dependent on opioids fell to 3,315 at the end of fiscal year 2017, a 19 percent drop from 2016 and a 59 percent decrease since 2011.

“That means we have 4,714 fewer injured workers at risk for opioid addiction, overdose and death than we had in 2011,” said Trego, speaking before the board’s Medical Services and Safety committee. “These falling numbers are the direct result of our efforts to improve our protocols, more closely monitor our opioid population and encourage best practices from our prescribers. But we also have to give credit to the growing awareness of the opioid epidemic and efforts by the health care community, government and others to do something about it.”

Trego also told board members his department’s total drug costs fell to $86 million in 2017, $47 million less than in 2011. That includes $24 million less on opioids.

Working with addiction experts, BWC in 2011 defined “clinically dependent” as any person who took the equivalent of at least 60mg a day of morphine for 60 or more days. They found more than 8,000 injured workers who met that threshold at the end of 2011, prompting several initiatives to reduce those numbers and improve BWC’s pharmacy operations.

Ensuing changes included the creation of a pharmacy and therapeutics committee, a panel of physicians and pharmacists that creates and reviews medication policy; the development of BWC’s first-ever, and now nationally-recognized, formulary and the 2016 Opioid Rule. Among several safeguards, the rule holds prescribers accountable if they don’t follow best practices.

Trego told the board he expects BWC’s opioid numbers to continue to fall in the years ahead as prescription protocols evolve and alternative pain therapies emerge.

“Weaning a dependent person off opioids, or at least to safer levels, is a long, deliberate process requiring cooperation from the injured worker, health care providers and the worker’s support network,” Trego said. “We’re just one part of that equation, but we’re committed to it.”