NU Online News Service, Jan. 5, 11:23 a.m. EST

Narcotics, used primarily to alleviate back pain, account for nearly one quarter of all workers’ compensation prescription drug costs, according to a recent study.

The findings were contained in a report from the National Council on Compensation Insurance.

NCCI also noted that the narcotics share of drug costs increases as claims age. “The medical community seems divided over the suitability of narcotics to treat other forms of pain, such as those resulting from the majority of workers’ compensation injuries,” the group said.

It noted a report that the Food and Drug Administration is working on a framework to ensure the safe, appropriate use of narcotics, with the aim of creating a program ensuring that only physicians properly trained in safe use of narcotics may prescribe them.

In at least one state, according to a report mentioned by the NCCI study, diagnoses of “chronic pain” or “failed back syndrome” virtually guarantee that the claim involves over-prescription of narcotics because these are the diagnoses used to justify the use of such drugs.

The NCCI study examines use and prescribing patterns of what it referred to in a statement as “this controversial category of drugs in workers’ compensation.” It listed among its key findings:

o The narcotics share of drug costs increases as claims age–until the eighth service year when it levels off.

o Narcotics costs per claim vary by state, with apparent regional differences.

o Narcotics are used mostly for back injuries in workers’ comp.

o Narcotics use early in the life of claims is increasing.

o Narcotics use can persist for many years.

o Heavy narcotics use for workers’ comp injuries is related to substance-abuse treatments.

o Narcotics accounts for nearly 25 percent of all workers’ comp prescription drug costs.

NCCI said data used in the study was consolidated from a sample of claims data provided by select carriers for injuries that occurred from 1994 to 2007, and services provided from 1996 to 2007, evaluated as of July 1, 2008. NCCI said it could not include drug costs that were bundled with other services.

The study found high-cost narcotics are a greater portion of narcotics prescriptions as claims age–exceeding 40 percent in the 12-years of servicing a claim.

Most narcotics prescription costs are for the active ingredient hydrocodone (57.6 percent), followed by oxycodone (21.3 percent).

Narcotics costs per medical claim were said to be above average in New Hampshire, Maine, South Carolina, Alabama, Louisiana, Oklahoma, Texas and California. Most Midwestern states were below average.

The study can be viewed online at https://www.ncci.com/documents/Narcotics_in_WC_1209.pdf.