A new study, Factors Associated With Persistent Opioid Use Among Injured Workers’ Compensation Claimants, published online in the journal JAMA Network Open. says that many injured workers turn to opioid painkillers for relief, and nearly 30 percent may still be taking them three months after their injury — increasing the odds of addiction.
The number of opioid prescriptions per workers’ compensation claim in the United States has climbed considerably since 2003, according to the NCCI Workers’ Compensation Prescription Drug Study – 2013 Update. However, the researchers also noted that there “is a paucity of data on persistent opioid use and factors associated with persistent opioid use among workers’ compensation claimants.” Thus they decided to conduct this new study.
For the study, the researchers collected data on nearly 9,600 injured workers who filed workers’ compensation claims in Maryland from 2008 to 2016. All patients were initially treated with opioids. The objective of this study was to determine the proportion of injured workers who filled an opioid prescription beyond 90 days from their time of injury and the factors associated with persistent opioid use among injured workers’ compensation claimants in Maryland.
The findings suggest workers’ compensation claimants have a high proportion of persistent opioid use.
2741 claimants (28.6%) with an initial opioid prescription filled at least 1 opioid prescription more than 90 days from the time of injury. Nearly 10% of the injured workers filled an opioid prescription beyond 365 days from their date of injury. Persistent opioid use was significantly associated with increased age, preinjury incomes of $60 000 or more, claims adjudicated as permanent total disability, and a concomitant diagnosis of chronic joint pain or another pain diagnosis such as migraines or fibromyalgia. Claimants with crush injuries and strain or sprain injuries were 50% more likely than those with soft-tissue or contusion injuries to have persistent opioid use.
Researchers concluded that “the proportion of injured workers with persistent opioid use substantially exceeds recent reports on surgical patients at 90 days (28.6% vs 6.0%) and the national rate at 1-year from initial therapy reported by the Centers for Disease Control and Prevention.”
“Many of our findings were consistent with previous research. Patients with a chronic joint pain diagnosis were more likely to be persistent opioid users.” The researchers also conceded that ” It is possible that some participants sought a chronic pain diagnosis to justify a continued disability claim.”
“The strong association between persistent opioid use and chronic pain diagnoses are concerning and may highlight a critical gap between national evidence-based guidelines and actual prescribing practices.“
US News adds to the study by reporting that the main concern shared by doctors is the use of opioids for non-acute pain, said senior researcher Dr. Gerard Slobogean, an assistant professor of orthopedics at the University of Maryland School of Medicine. “Physical therapy, other complementary and alternative therapies, as well as non-opioid medical therapies, should be considered for many injured workers,” he said.