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Few physicians are following prescribing guidelines for painkillers, study finds

Many physicians who prescribe powerful painkillers, such as Oxycontin and Vicodin, for injured workers fail to follow recommended treatment guidelines for monitoring their patients, resulting in long-term use of the drugs that may lead to addiction, according to a new report from a Cambridge-based research group.

Nearly one in 12 injured workers who are prescribed narcotics are still using them three to six months later, concludes the study by the Workers Compensation Research Institute, a non-profit organization.

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The study found that workers prescribed these medications infrequently received recommended drug test monitoring and psychological evaluation, which can help prevent misuse.

The findings come amid a rising sea of painkiller addiction in the U.S. The increase in drug overdose deaths in the U.S. parallels a 300% rise since 1999 in the sale of these strong painkillers, according to the Centers for Disease Control and Prevention.

The Institute combed through nearly 300,000 workers’ compensation claims from 21 states, including Massachusetts, from 2006 through 2009, and followed the prescriptions associated with those claims through March 31, 2011.

The Institute study did find encouraging news from Massachusetts. It found that the percentage of injured Massachusetts workers who had longer-term use of narcotics decreased from 11 percent to 7 percent during the time period studied, between 2007 until 2011.

The study said the decrease may be explained by certain regulatory changes in Massachusetts during those years, including a mandatory physician education program.

A 2010 state law requires prescribers, as a condition of license renewal, to receive training in effective pain management and identification of patients at high risk of abuse.

Massachusetts also launched a Prescription Monitoring Program,, a database aimed at stopping patients from doctor-shopping for highly addictive pain medications.

Under new rules signed into law by Governor Deval Patrick in August, doctors will be required to sign up and check the database, which allows providers to see whether a patient has received other narcotic prescriptions in the past year. Enrollment was previously voluntary, but fewer than 2,000 out of 40,000 prescribers statewide are currently registered.

An earlier report from the Institute found an uptick in longer-term opioid users among injured Massachusetts workers, between 2006 and 2009. The latest report said it is uncertain whether the more recent reversal will “necessarily hold for the longer term, but it is certainly worth close monitoring.”

Kay Lazar can be reached at klazar@globe.com. Follow her on Twitter @GlobeKayLazar.
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