Kansas better than Missouri at reducing worker’s comp opioid prescribing, study says

A study published this month by the Worker’s Compensation Research Institute found that Kansas has been better than Missouri at reducing dangerous prescribing of opioids for injured workers.

The study looked at more than 2 million prescriptions written from 2010 to 2015 for 400,000 non-surgical worker’s compensation claims in 26 states.

The researchers found that only four of those states reduced their long-term opioid dispensing more than Kansas during that time.

The study’s author, Dongchun Wang, defined long-term use of opioids as more than six months. Guidelines from the Centers for Disease Control and Prevention warn that using opioids to treat chronic pain for more than three months can do more harm than good because of the risk of addiction.

Worker’s compensation is just one piece of the larger opioid addiction and overdose crisis that President Donald Trump said Thursday he will declare a national emergency. It’s not clear yet what that will mean for state efforts to stem the problem.

In the worker’s compensation study, Kansas dropped its rate of long-term opioid prescribing from 5.6 percent in 2010-2012 to 3.4 percent in 2013-2015. Missouri’s rate only dropped from 3.9 percent to 3.7 percent.

Kansas finished the study with the lowest rate of any of the 26 states. Missouri ranked third behind Kansas and New Jersey (3.6 percent).

The labor departments that run the worker’s compensation programs in Kansas and Missouri did not respond to requests for comment on the study.

Wang provided several potential explanations for the decline in long-term opioid prescribing on the Kansas side.

▪ The Kansas Board of Healing Arts adopted a model policy, published by the Federation of State Medical Boards in 2013, for determining whether the doctors it licenses are following safe controlled-substance prescribing guidelines.

▪ The Kansas Department of Labor adopted evidence-based medical treatment guidelines from the Work Loss Data Institute meant to get injured workers back on the job as quickly as possible.

▪ Kansas’ prescription drug monitoring program, K-TRACS, went online in 2011, and every year more doctors and pharmacists have been using it to see whether their patients might be getting pain medications from multiple sources.

“The number of prescribers registered with the (Kansas) PDMP program has increased steadily, with nearly one-third of all prescribers enrolled as of December 2014,” the study states.

Missouri is the last state without a statewide prescription drug database. Efforts to establish one have been stymied for years by legislators who say they’re concerned about patient privacy.

In the absence of a statewide database, Jackson County and some other counties have started their own.

Missouri Gov. Eric Greitens signed an executive order last month to start work on a statewide database that would use claims information from the nation’s largest pharmacy benefits manager, Express Scripts, to help state officials spot suspicious opioid prescribing.

Greitens’ PDMP has been criticized because it will not allow doctors and pharmacists to access the data and because St. Louis-based Express Scripts, which donated to his inaugural, received a $250,000 no-bid contract for the project.

This story was originally published August 11, 2017 at 2:02 PM with the headline "Kansas better than Missouri at reducing worker’s comp opioid prescribing, study says."