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Are workers’ comp laws and insurers to blame for opioid crisis?

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A doctor testified in a lawsuit against Johnson & Johnson that workers’ compensation laws and insurers were to blame for the opioid crisis, not pharmaceutical companies. 

On Monday, July 15, 2019, closing arguments were made in Oklahoma’s $17.5 billion opioid crisis lawsuit against Janssen, a J&J subsidiary. The state sued the pharmaceutical company for creating a public nuisance by encouraging doctors to over-prescribe the prescription painkillers.

J&J called Dr. Terrell Phillips of Oklahoma City as its last witness in the seven-week trial. Phillips testified many insurers and workers’ comp laws will pay doctors only for “reasonable and necessary” treatment, and that often excludes physical therapy, injections and surgery, according to reporting by Courthousenews.com. The doctor said the only option left for doctors treating patients with chronic pain is to prescribe opioids.

Phillips said he’s “handcuffed” because if patients aren’t treated, it can lead to depression and suicide.

The judge hearing this case says he’ll issue his decision by Aug. 31.

Oklahoma also sued Teva Pharmaceuticals and Purdue Pharma, claiming fraud, unjust enrichment, public nuisance and violation of state Medicaid laws. Those two companies settled with the state: Purdue for $270 million and Teva for $85 million, before going to trial.

Paying for deaths

Under cross-examination, Phillips said J&J was paying him up to $450/hour for preparation and $10,000 per day for testifying, but he said money wasn’t the reason he testified.

Phillips isn’t the only one making the connection between workers’ comp and the opioid crisis. In 2015, the National Safety Council released a paper that concluded courts are forcing companies to pay workers’ comp death benefits to families of injured employees whose addiction and death resulted from opioids prescribed for work injuries.

The NSC paper focused on six cases, including this one we wrote about in Safety News Alert. The safety organization says 45 people die per day in the U.S. from opioid prescription overdoses – more than from heroin and cocaine combined. Oklahoma says 4,600 of its residents died from accidental prescription opioid overdoses from 2007 to 2017.

Also supporting Phillips’ point of view, research by the Massachusetts Department of Public Health funded by the U.S. Centers for Disease Control and Prevention said the rate of fatal opioid-related overdose was higher among workers in industries with high injury rates, such as construction.

The NSC recommends employers:

  • educate workers about the risks of opioids
  • work with insurance carriers to identify inappropriate opioid prescribing, and
  • ensure medical providers follow prescribing guidelines and use state prescription drug monitoring programs which track prescribing history.

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