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Use of stronger, Schedule II opioids increases in Calif. comp claims

Use of stronger, Schedule II opioids increases in Calif. comp claims

Utilization of Schedule II opioids in California workers compensation claims has grown steadily in the last decade, along with payments for such medications in comp claims, according to the California Workers Compensation Institute.

Schedule II opioids represented 7.3% of California workers comp prescriptions in the first half of 2013, up from 1.3% for all of 2002, Oakland, California-based CWCI said in a report released Tuesday.

Meanwhile, Schedule II opioids represented 19.5% of workers comp prescription payments in the first half of last year, up from 4.7% in 2002, CWCI said.

Schedule II controlled substances require a doctor's prescription and refills are not allowed. Such medications include oxycodone, morphine, fentanyl and methadone.

CWCI said utilization and payments for Schedule II opioids fell slightly from 2004 to 2005 after a series of workers comp reforms were approved around that period. However, that decline was not sustained.

“By 2006 ... the use of Schedule II opioids to treat injured workers began to accelerate rapidly, consuming a growing proportion of the workers' compensation prescriptions and prescription dollars,” the report reads.

Oxycodone represented 58.3% of all Schedule II prescriptions from 2002 to 2013 and 55.7% of all Schedule II payments during that time, the most of any Schedule II opioid in California comp claims, CWCI said.

Schedule III opioid utilization and payments have declined slightly in California over time, CWCI said. Such medications are considered by the U.S. Food and Drug Administration to have a “moderate to low” potential for abuse or dependence, and include hydrocodone/acetaminophen combination pills.


Schedule III opioids represented 19.3% of California workers comp prescriptions and 10.3% of workers comp prescription payments in the first half of 2013. That’s down from 20% of prescriptions and 11.1% of payments in 2002, CWCI said.

CWCI said the use of a closed prescription formulary, such as those used in Texas and Washington, could help reduce opioid utilization and costs in California by restricting the types of drugs available to comp claimants.