Persistent Opioid Use in Injured Workers

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Individuals who had claimed workers’ compensation and who had ≥1 opioid prescription filled were included in the final analysis.
Individuals who had claimed workers’ compensation and who had ≥1 opioid prescription filled were included in the final analysis.

A high percentage of individuals who claim workers' compensation were found to have persistent opioid use, according to a study published in JAMA Network Open. Strain and sprain injuries, older age, and higher income were associated with a greater likelihood of persistent opioid use in this population.

Maryland workers' compensation claims data filed between January 2008 and December 2016 were retrospectively reviewed. Individuals who had claimed workers' compensation and who had ≥1 opioid prescription filled were included in the final analysis (mean age, 43±12.3; n=9596). Persistent opioid use (ie, opioid prescriptions filled >90 days after injury) was the study's primary outcome.

A total of 2741 patients (28.6%) were found to have filled an opioid prescription >90 days from the date of their injury. Factors associated with persistent opioid use in these patients included strain and sprain injuries (odds ratio [OR], 1.54; 95% CI, 1.36-1.75), crush injuries (OR, 1.55; 95% CI, 1.28-1.89), having an annual income >$60 000 (OR, 1.31; 95% CI, 1.07-1.61), having concomitant chronic joint pain diagnosis (OR, 1.98; 95% CI, 1.79-2.20), and being age ≥60 (OR, 1.92; 95% CI, 1.56-2.36). Individuals who filed medical-only workers' compensation claims were less likely to report persistent opioid use 90 days after injury compared with individuals with permanent partial disability claims (OR, 0.17; 95% CI, 0.15-0.20).

Limitations of the study include the lack of data on durations and doses of opioid treatment as well as the inclusion of claims from a single insurance company.

“To curb the opioid epidemic and prevent the untimely deaths of scores of Americans policies to support alternative pain management therapies that minimize opioid therapy should be investigated, particularly for high-risk patients identified in this study with nonspecific diagnoses such as strain or sprain injuries,” noted the study authors.

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Reference

O'Hara NN, Pollak AN, Welsh CJ, et al. Factors associated with persistent opioid use among injured workers' compensation claimants. JAMA Network Open. 2018;1(6):e184050.

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