HARRISBURG – The state Department of Health unveiled new opioid prescribing guidelines for injured workers, as a means of improving the state’s record as one of the worst in the country for over-prescribing of opioids.
“In 2017, there were more than 17,000 workers’ compensation claims made in Pennsylvania, and our state ranks third highest in the nation in the percentage of injured workers who become long-term opioid users,” Gov. Tom Wolf said.
The new guidelines were announced Monday as part of an update on the state’s opioid emergency response. The U.S. Centers for Disease Control has estimated drug overdoses, fueled by the opioid epidemic, topped 5,600 in Pennsylvania last year.
Health Secretary Dr. Rachel Levine said that under the guidelines doctors are encouraged to use the smallest dose possible for the shortest period possible when prescribing medicine to people suffering from acute pain. For chronic pain sufferers, doctors are being encouraged to find alternatives to opioids, she said.
Health officials recognize opioids can be essential medicine for treating people with certain conditions, she said. “Opioid stewardship” efforts require coming up with ways to dissuade doctors from overprescribing the addictive painkillers, she said.
“The workers’ compensation prescribing guidelines are intended to supplement, not replace, clinical judgment,” Levine said.
The move to develop new prescribing guidelines for injured workers follows similar recommendations related to opioid prescribing in 10 areas, including for sports injuries, dental work and obstetrics.
The move also comes less than three months after Wolf vetoed legislation lawmakers had touted as a way of solving the same problem of overprescribing painkillers for injured workers. That legislation would have created a drug formulary for the workers’ compensation program.
Levine said administration officials believe the new guidelines are more focused on deterring opioid overprescribing than the formulary would have been.
The drug formulary plan had been championed by business groups and Monday, Pennsylvania Chamber of Business and Industry President Gene Barr said he still thinks Wolf was wrong to veto the measure.
“While we appreciate the Wolf administration’s focus on the opioid epidemic and recognition of its impact on injured workers, we remain deeply disappointed with the governor’s decision,” Barr said.
Ray Barishansky, deputy secretary for health planning and assessing in the Department of Health, said health officials need to take a long view when measuring the progress against the opioid epidemic.
“This is going to be a marathon, not a sprint,” he said.
The issue of over-prescribing by doctors has been become an area of increased focus in recent years. Act 124 of 2016 required doctors to take new continuing education classes on appropriate opioid prescription practices. The state also rolled out a new prescription drug monitoring program to better identify doctors who are prescribing too many opioids and patients who are doctor-shopping to get unnecessary medication.
The efforts have started to pay off. The American Medical Association announced in June that Pennsylvania doctors wrote 1.3 million fewer opioid prescriptions in 2017 than they had a year earlier.