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The prescribing of medications deemed to be pain treatment alternatives to opioids has significantly risen in California.
Anti-inflammatory drugs often prescribed for pain and inflammation now represent the largest percentage of drugs prescribed to injured workers in California, and the drug spend on pain-relieving topical creams grew 74.3% between 2009 and 2018, according to a study released by the California Workers’ Compensation Institute in February.
Such drugs have replaced opioids as the top drug in comp one year after the state enacted a drug formulary that limited opioid prescribing to injured workers, according to the study by the Oakland, California-based institute.
Anti-inflammatories represented 31.7% of drugs prescribed to injured workers in California in 2018, according to the data. In each of the six years prior to that, opioids were the top therapeutic drug category dispensed, with anti-inflammatories ranking second.
Although dermatological prescriptions only increased from 5% of all prescriptions in 2009 to 5.6% in 2018, the study found that over that same period their share of the total drug spend climbed from 10.1% to 17.6%, “indicating an increase in the average amount paid for dermatological prescriptions,” the study stated.
In 2018, opioids accounted for 18% of prescriptions, down from a high of 30.5% in 2009 — representing a 41% decrease over nine years, according to the study.
Anticonvulsants, a class of drugs originally intended and only federally approved to treat epilepsy, are increasingly commonplace in treating injured workers for pain, producing mixed reactions from workers compensation experts.