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Opioid law provides limited relief to big problem

Opioid law provides limited relief to big problem

Corrected: An earlier version of this story incorrectly included a reference to an anti-overdose drug.

A federal law aimed at cutting opioid addiction lacks sufficient funding and scope, but observers say it still could ease a problem that is a major issue for the workers compensation sector.

In particular, by increasing education efforts and introducing prescription reporting at the national level, the measure will help employers and insurers curb some abuse of the addictive drugs, they say.

Late last month, President Barack Obama signed the Comprehensive Addiction and Recovery Act into law as part of an effort to raise awareness of the risks of opioid addiction and provide practical solutions to curtail addiction and overdoses.

He expressed disappointment, however, regarding the limited scope of the law.

“This legislation includes some modest steps to address the opioid epidemic. Given the scope of this crisis, some action is better than none,” Mr. Obama said in a statement. “I am deeply disappointed that Republicans failed to provide any real resources for those seeking addiction treatment to get the care that they need.”

The president had requested more than $1.1 billion be allocated for the program. The law, however, allows only $181 million a year.

“One hundred and eighty million dollars is nothing, but now politicians can claim they are doing something about the opioid crisis without actually doing anything,” said Joe Paduda, Skaneateles, New York-based president of CompPharma L.L.C., a workers comp pharmacy benefit management consortium.

However, Rita Wilson, Delray Beach, Florida-based CEO of claims administrator Tower MSA Partners L.L.C., said, “Any act from a regulatory position that focuses on opioids is an extremely positive thing.”

Provisions in the law that affect workers compensation include:

• lEstablishing national electronic prescription reporting;

• Increasing from 100 to 275 the number of patients that qualified opioid treatment providers can oversee while expanding the definition of treatment providers to include law enforcement and nurse practitioners;

• Providing federal grants to states to train prescribers on best practices for opioids and to educate the public; and

• Funding federal research on new pain medications that are less addictive.

Other provisions in the law will finance treatment programs for veterans, young athletes, pregnant women and babies addicted to opioids. The law also will aid drug smuggling investigations.

Federal involvement is key, Ms. Wilson said.

“Having prescription drug monitoring programs, educational components and access to information not only at state level but now at a federal level shows great support for what workers comp carriers, employers and payers have been trying to do,” she said.

The educational provisions aimed at patients and prescribing physicians are the most promising aspect of the law, she said.

“Legislation that funds education that can impact prescribing habits is a tremendous opportunity for that change we hope to see,” she said of the law that will allow states to apply for federal grants to expand their efforts.

“Efforts that create even greater awareness in the medical community about pain management and opioid prescribing practices, as well as increased focus on prevention, treatment and education are positive steps in helping injured workers return to health and avoid opioid addiction,” Peter Macdonald, Hartford, Connecticut-based vice president of workers compensation claims at The Hartford Financial Services Group Inc., said in an email.

The law's easing of limits on patients that addiction treatment providers can handle also is welcome, said CompPharma's Mr. Paduda.

“There are millions who are addicted to opioids that are on waiting lists to get into these treatment facilities,” he said.

The law also expands treatment availability to qualifying licensed nurse practitioners and physician assistants who have expertise in prescribing medications for opioid use disorder. Currently, only select trained physicians can do so.

Mark Pew, senior vice president at Duluth, Georgia-based medical management company Prium, said when the detox and maintenance drug buprenorphine began to get greater use at the turn of the century, the number of patients per doctor was limited to 100, but experience has won doctors' support of the expanded limit of 275.

Since the increase in opioid prevention and treatment programs will be at the state and local levels, Thomas Ryan, New York-based market research leader at Marsh L.L.C.'s Workers Compensation Center of Excellence, said he hopes that will put workers on a fast track for recovery.

The law's electronic prescription reporting at a national level also will help reduce abuse, he said.

Currently, some workers comp claimants get prescriptions from multiple doctors, “With no way to track this, there is the high propensity for abuse,” Mr. Ryan said.

An electronic database with the history of all prescription information will help states monitor drug dispensing by providing a line of vision for providers and insurers to investigate any drug abuse situation, he said.

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