Dreamland: Part 2: Fifty, Hundred Cases a Month Summary & Analysis

Washington State holds a monopoly on insuring workers. Labor and Industries (L&I) employee Jaymie Mai, thus, is in a unique situation. Since 2000, Mai, a pharmacist, has been in charge of overseeing workers comp cases. She begins to notice a disturbing trend: painkillers are being inappropriately prescribed to workers in alarming numbers. More disturbing than this, workers who are prescribed the painkillers begin dying, including those whose initial complaints were simple ailments like a sprained knee. In the past, most deaths could be accounted for by accidents like electrocutions or from cancer.

Mai immerses herself in research. In 2005, Mai and her boss Gary Franklin publish a paper in the American Journal of Industrial Medicine attesting to the increased number of workers who have died from prescription painkillers between 1995 and 2002. Most of these workers initially entered into the worker’s comp system with non-life-threatening conditions. The paper is met with backlash from people who don’t want their meds taken away. Mai and Franklin contact Jennifer Sabel, an epidemiologist with the Washington state department of health, to see whether the trend in rising opiate deaths in worker’s comp data is mirrored across the state’s entire population.