Fentanyl Often Prescribed in Calif. Workers’ Comp

A CWCI Research Spotlight Report on the use of fentanyl – the most potent Schedule II opioid – in California workers’ comp finds that More than 1 out of every 5 injured workers in California who are prescribed Schedule II opioids receive fentanyl, while more than a quarter of all claimants with non-surgical medical back problems who are prescribed Schedule II opioids receive fentanyl, according to a new report by the California Workers’ Compensation Institute.

CWCI said in its Research Spotlight Report on the use of fentanyl that the drug is the most potent Schedule II opioid. The report was a follow-up to a study published last month, in which CWCI found that the top 10 percent of doctors who prescribe extremely potent, addictive Schedule II opioids for injured workers in California account for nearly 80 percent of all workers’ compensation prescriptions for these narcotic drugs, and that nearly half of the prescriptions were for minor back injury claims.

As in the earlier analysis, the new study found that most of the fentanyl prescriptions for injured workers were written by a small percentage of the Schedule II opioid prescribers, with the top 10 percent accounting for 84 percent of the prescriptions. Use of fentanyl to treat non-surgical medical back problems was more widespread, however, as the top 10 percent of Schedule II prescribers accounted for 72 percent of the fentanyl prescriptions written for these claimants.

Most of the fentanyl prescriptions were transdermal patches, which have limited FDA approved uses and have been the subject of multiple FDA warnings, CWCI said. California workers’ compensation pain management guidelines also say the patches should only be used for chronic pain patients requiring round-the-clock therapy, who have developed a tolerance for other opioids, and whose pain cannot be managed by other therapy.

For more information, visit the Research section of CWCI’s Web site www.cwci.org/research.html.