American journal of industrial medicine · 2024
Association Between Pre-Injury Opioid Use and Opioid Use Patterns After a Work Injury.
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Fulton-Kehoe Deborah, Haight John, Elmore Andrea, Sears Jeanne M, Wickizer Thomas, Franklin Gary M
Аннотация
BACKGROUND: Few studies have assessed long-term opioid prescribing after a work-related injury. There is limited information about opioid prescriptions before an injury and how receipt of opioids before a work injury is associated with long-term opioid prescribing. We present patterns of long-term opioid prescription among workers after an injury, overall, and by pre-injury opioid use.
METHODS: We used linked workers' compensation and prescription drug monitoring program (PDMP) data to identify workers injured between July 2019 and June 2020 with an opioid prescription dispensed within 6 weeks after injury. Opioid prescribing was assessed for the 3 months before injury and for 1 year after injury or claim closure, whichever came first.
RESULTS: Among injured workers with an opioid in the first 6 weeks, 23% had opioids 6-12 weeks after injury, 19% had opioids 3-6 months, 14% had opioids 6-9 months, and 12% had opioids 9-12 months after injury; 19% had opioids in the 3 months before injury. For workers with opioid prescription prior to injury, the percentage with opioids 9-12 months after injury was 34%, versus 7% among workers with no opioids in the 3 months before injury (p < 0.001). Receipt of chronic opioids (for at least 60 days) 9-12 months after injury was substantially higher among those with prior opioid prescription (20%) than in those with no prior opioids (0.4%) (p < 0.001).
CONCLUSIONS: We found a strong relationship between opioid prescription in the 3 months before a work injury and opioid prescribing after an injury. Healthcare providers should be vigilant to the important relationship between prior opioid use and longer-term opioid use after work-related injuries.
METHODS: We used linked workers' compensation and prescription drug monitoring program (PDMP) data to identify workers injured between July 2019 and June 2020 with an opioid prescription dispensed within 6 weeks after injury. Opioid prescribing was assessed for the 3 months before injury and for 1 year after injury or claim closure, whichever came first.
RESULTS: Among injured workers with an opioid in the first 6 weeks, 23% had opioids 6-12 weeks after injury, 19% had opioids 3-6 months, 14% had opioids 6-9 months, and 12% had opioids 9-12 months after injury; 19% had opioids in the 3 months before injury. For workers with opioid prescription prior to injury, the percentage with opioids 9-12 months after injury was 34%, versus 7% among workers with no opioids in the 3 months before injury (p < 0.001). Receipt of chronic opioids (for at least 60 days) 9-12 months after injury was substantially higher among those with prior opioid prescription (20%) than in those with no prior opioids (0.4%) (p < 0.001).
CONCLUSIONS: We found a strong relationship between opioid prescription in the 3 months before a work injury and opioid prescribing after an injury. Healthcare providers should be vigilant to the important relationship between prior opioid use and longer-term opioid use after work-related injuries.