Why these employees are the most opioid-prescribed feds

Why these employees are the most opioid-prescribed feds

https://www.federaltimes.com/federal-oversight/watchdogs/2019/06/10/why-postal-employees-are-the-most-opioid-prescribed-feds

Nationwide efforts to address the opioid epidemic have resulted in a reduction in the number of opioids prescribed to patients and the length of time a physician can prescribe such medication to a patient without extenuating circumstances.

But a June 6 report by the U.S. Postal Service’s Office of Inspector General found that the number of postal workers who receive opioid prescriptions under the Federal Employees’ Compensation Act program has not seen a similar reduction.

“Specifically, although the cost of opioid prescriptions for the Postal Service employee FECA population declined from 2016 to 2018, the rate of decline was substantially less than that for other federal agencies,” the report said.

“We also found that between 2014 and 2017, the average number of prescriptions per Postal Service employee under FECA increased from about 6.2 to about 6.8. The [Centers for Disease Control] reported the number of opioid prescriptions per patient nationwide decreased from about 3.7 per patient in 2014 to about 3.4 in 2017. An increasing number of prescriptions per employee could indicate an increased risk of opioid misuse.”

According to 2018 Department of Labor statistics, the U.S. Postal Service employs one of the largest groups of federal employees at 610,528 workers. That is second only to the Department of Defense, which employs over 700,000.

Such employees occupy arguably some of the most dangerous jobs in the federal government.

Despite making up approximately 21.6 percent of the federal workforce, Postal Service employees account for over 50 percent of reported workplace injuries and illnesses and 56 percent of fatalities, according to Occupational Safety and Health Administration statistics.

In 2018, seven percent of the Postal Service workforce reported an injury or illness.

That high rate of injury can cause a high rate of opioid prescriptions.

According to the OIG report, nearly three percent of the Postal Service workforce received an opioid prescription in 2018 and accounted for 48 percent of the opioid prescription costs under the federal employee FECA program.

Those prescriptions cost the FECA program nearly $22 million in 2018, according to the report.

“The risk of misuse is increased because employees can get additional opioid prescriptions outside of the FECA program,” the report said.

Due to the addictive nature of opioids, the CDC has issued guidance that opioids be prescribed for no more than three days, except in cases of medical necessity, and 25 states have set that same limit at one week or less.

The Department of Labor, however, allows physicians to prescribe opioids to new users under the FECA program for up to 60 days without a letter of medical necessity.

That difference is significant, as CDC research has proven that over 13 percent of patients prescribed opioids for eight days or more were still taking them a year later. That rate jumps to 30 percent if the patient has been taking opioids for a month or more.

OIG investigators found that Postal Service officials haven’t properly tracked the statistics available from the DOL, which would give them better insight into where there could be potential opioid abuse problems in their workforce.

“When the Postal Service does not use data analysis, it cannot assess and anticipate any associated workforce issues and take targeted action to help protect its employees and customers from the dangers of prescription drug addiction,” the report said.

Compounding this issue, investigators determined that the Postal Service had not developed a sufficient drug policy and drug education plan, with insufficient data to determine how many of its employees were reached by current education measures.

The report recommended that the Postal Service develop a quarterly data analysis plan for opioid use, request that the DOL reduce the prescription length allowed under FECA, update supervisory policy to ensure supervisors understand the impact opioid use could have on mental or physical abilities and develop a comprehensive, ongoing educational plan.

Postal Service management agreed with the first two recommendations but disagreed that they needed to update supervisor policies or educational plans.

 

4 Responses

  1. Question about opioid prescription data in reports like these: There was a time that doctors could write a 90-day prescription for (let’s just say) Vicodin. So, 4 such prescriptions would last a patient one year.

    Then (I forget the year the change took place), that maximum was capped at 30-days. Same patient now needs 12 such prescriptions to cover the same time period. Would that regulatory change cause agencies like the CDC and DEA to report a 3-fold increase in the # of prescriptions?

    Further, there was a time I was able to obtain a 45-mg pain medication (one prescription), until it was removed from my insurance plan’s formulary, to be replaced by a 30-mg pill and a 15-mg pill (necessitating two scripts). Same question: would the “official reports” now reflect 2x the number of prescriptions (based on a rather meaningless change)?

    PS. This assertion from the article is easily debunked (“That difference is significant, as CDC research has proven that over 13 percent of patients prescribed opioids for eight days or more were still taking them a year later. That rate jumps to 30 percent if the patient has been taking opioids for a month or more,”) for it states the obvious: a signficiant minority of injured patients will go on to experience chronic pain, and chronic pain requires indefinite treatment. Where’s the newsflash here?

    • There has been a similar corrupt view at the Veterans affairs! Now that I’m going to a doctor outside the VA, I see him every three months only depending upon prescription timing! At the VA, I would get an appt. to dive 120 miles almost three times a month and received less care! One trip would be for lab work, then days later one to see a doctor and then as literally all vets do, another for a psych. appt. This is what they called “patient centered” care. Drive 360 miles a month and they take your meds. While in the private sector, 30 miles every three months and the only reason meds were taken is that the VA started the “no cocktail” rule because they overdosed someone while in a Wisconsin VA hospital. The things the VA does are more aligned to protect VA jobs than provide “patient centered” care!

    • Yes, they would report an increase. And did. Then they tried to fix the numbers a few times over but never got the true number due to each substance in the body being counted as a death. Math really isn’t as hard as they make it look.

    • You are correct and don’t forget that Tramadol (Ultram) was also added to the controlled substance list shortly after Vicodin ,Ultram was not a controlled med when introduced around 1993.

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