The number of injured workers who depend on opioids has declined 19% in Ohio’s workers’ compensation system, the sixth year in a row that the number has fallen since the Bureau of Workers’ Compensation adopted a formulary. 

Nick Trego

BWC Pharmacy Director Nick Trego told the agency’s board of directors during a meeting Thursday 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% drop from 2016 and a 59% decrease since 2011, the BWC said in a press release.

“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 said 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.

BWC in 2011 adopted a definition of “clinically dependent” as any person who took the equivalent of at least 60 milligrams a day of morphine for 60 or more days. The bureau initiated several plans to improve its pharmacy program after discovering 8,000 workers met the definition.

The bureau developed a formulary that controls the types of medications that physicians may prescribe. In 2016, the board adopted an opioid rule that included several safeguards, including holding prescribers accountable if they don’t follow best practices.

Trego during the board meeting said 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.”