Wednesday, June 6, 2012

NCCI Narcotics Report: The More You Get... The More You Get

Of all the interesting statistics contained in the new NCCI research brief, the one that stood out most to me was the section entitled "Early Narcotic Use Is Indicative of Prolonged Use."  Turns out, the earlier one gets narcotics and the higher the dose one receives... the longer one will likely be on the drugs and the higher the dose will likely be.

If ever there was an analysis that supported early intervention on claims where narcotics are being utilized, this is it.  Most of us have felt this intuitively, but this is the first analysis I've seen detailing the extent of the issue.   

Some highlights:

- Shockingly, about 10% of claimants receive > 825 mg MED in the first quarter following injury.  50% of all claims receive between 100 mg MED and 370 mg MED in the first quarter following injury.  Recall the 120 mg MED threshold from my post earlier this week.  That's a monthly metric, not quarterly... but I was still surprised at the prevalence of high doses of narcotics early in the claim life.

- 63% of claimants with MED > 825 mg in the initial quarter following injury continued to receive narcotics in the second quarter following injury.  Only 35% of claimants receiving between 370 mg and 825 mg MED in the first quarter post-injury continue to receive narcotics in the next quarter. 

- The graphics NCCI put together on this topic are compelling.  Check out Exhibits 8 and 9.  Once a claimant is on high doses of narcotics, that claimant is highly likely to remain on high doses of the drugs.  For the 10% of claimants that start out on > 825 mg MED, the average MED in the first quarter post-injury appears to be in the range of 2,000 mg MED (or approximately 650-700 mg MED per month).  By the 20th quarter post injury, this cohort averages around 7,000 mg MED (or over 2,000 mg MED per month). 

This is unfathomable.  And it begs the obvious question for further analysis: What is the death rate, by quarter, in the > 825 mg MED cohort? 

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