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Florida restriction on strong opioids shifted patients to other drugs

December 31, 2014
by Gary A. Enos, Editor
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A Florida policy change that shifted the dispensing of strong opioids for injured workers from physicians to pharmacies led to the prescribing of weaker medications for more individuals, suggesting that some of the original prescribing of stronger medications was unnecessary.

These findings were documented in a study released this month by the Workers Compensation Research Institute, which had expected to discover that there would be little change in the percentage of workers compensation patients receiving strong opioids after the change was implemented. Instead, study authors found increases in physician dispensing of both weaker opioids and non-steroidal anti-inflammatory drugs.

Moreover, only 2% of individuals who received weaker medications in the first six months after the state's reform subsequently received stronger opioids from a pharmacy in the following six months, the study found. Florida's ban on physician dispensing of strong opioids took effect in July 2011.

Institute executive director Richard Victor said of the findings, “This raises concerns that a significant proportion of pre-reform physician-dispensed strong opioids were not necessary, which means injured workers in Florida were put at greater risk for addiction, disability or work loss, and even death.”

Victor added, “Since Florida has banned physician dispensing of strong opioids, the lessons of this study are relevant for the other states concerned about eliminating unnecessary costs in their system while protecting injured workers from unnecessary medical care.”



It seems to take a very large leap of faith to assume that the doctors in Florida prescribed "weaker opioids" because they thought the injured person's pain was "not that bad". A more reasonable view on this is that the DEA has scared Florida doctors into prescribing less potent opioids (or none at all) for fear of being on one of their "lists" and being accused of unethical practice habits. Eliminating doctors dispensing opioids was a great idea and should continue, but evaluation by the "Workman's Comp Authorities" is not likely to give an unbiased evaluation of any results. The way this article was written is a good example of this. No where in the article did anyone mention any pain or healing problems encountered by the injured parties. When you let this happen it seems to be similar to "the fox guarding the henhouse". I hope future articles will be put under better scrutiny.