IAIABC Opioid Decision is Matter of Life and Death

24 Feb, 2013 Bob Wilson


Over 20,000 people die from prescription drug overdoses in this country every year. That is one every 20 minutes or so. Not all of them are workers' comp related, but a significant number are.

As an industry we have blood on our hands, and it isn't going away anytime soon.

Several weeks ago, the Executive Committee of the International Association of Industrial Accident Boards and Commissions (IAIABC), stunned the industry when it abruptly abandoned a yearlong effort to craft model opioid rules that jurisdictions could look to in dealing with this issue. Several of us have written about this, and there has been general confusion as to why the IAIABC EC did what it did. In an attempt to clarify their position, they released a statement last week, which appeared on this site, saying that the Executive Committee “determined that adopting model legislation and regulation on opioid use could be interpreted as too narrow and restrictive for jurisdictions”. Stating that they have not abandoned the cause, they will refocus their efforts with “plans to move forward with a resource paper” that they “believe will benefit all jurisdictions, regardless of their legislative or regulatory structures”. They hope to have the paper available by the end of April.

Meanwhile, in the time that has elapsed since their decision and the publishing of this article, 1,425 families have buried their dead, or are in the process of doing so. By the end of April that number will be 4,876. Not all of them are workers' comp related, and frankly they all would still die even if the rules had been approved. These things take time. But next year's numbers might have been better. And the following year better than that. But we will never know.

I applaud the Executive Committee for responding and reaffirming their commitment to address the issue, however, I need to be very, very clear here. The opioid issue is a crisis. In times of crisis, leadership is critical. Leaders direct. Leaders motivate. Leaders inspire. Leaders lead.

Academics and policy wonks write papers.

There are leaders at the IAIABC. Right now they are found in the Medical Committee that toiled for more than a year to bring these models to life. They based much of their work on successful attempts in Washington and Texas, and worked very hard to create useful, meaningful examples that others could draw on. The EC decision on the end result of their work, the determination that "adopting model legislation and regulation on opioid use could be interpreted as too narrow and restrictive for jurisdictions", does not make sense. There has been precedent set on this issue.

The IAIABC has successfully crafted model rules for other issues in the past. Model rules are just that - model rules. No one expects every jurisdiction to follow in lock step. They were designed to show a framework for a path to success, not to be a draconian measure from which jurisdictions had no flexibility. I still find the suggestion that a model framework is inappropriate in this case to be absurd.

No, while the Medical Committee showed true leadership on the opioid crisis, the Executive Committee did not. The true reasons are unknown, but I suspect it was a political or image issue that got in the way for some of its members. If that is the case, it makes this decision all the more tragic. This is a case of critical substance that was sidelined by perception, and that makes this a colossal failure of epic proportions. 

I would continue to urge the Executive Committee to reconsider, and to lead on this issue by approving a comprehensive set of model rules and legislation on opioid use within the workers' compensation industry. It is, after all, a matter of life and death.

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