Script supply predicts long-term opioid use in injured workers

  • Durand Z & al.
  • JAMA Netw Open
  • 03.07.2019

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Injured workers who received a ≥20-day supply of opioids were significantly more likely to develop long-term opioid use than patients who received
  • Other risk factors included visiting ≥3 prescribers within 90 days of injury, receipt of a long-acting opioid within 30 days of injury, concomitant opioid and benzodiazepine prescriptions, and maximum morphine milligram equivalents (MMEs) received within 30 days of injury.

Why this matters

  • This is the first known study to examine the factors associated with increased risk of long-term opioid use among injured workers.

Study design

  • Study of 46,399 opioid-free injured workers (age, 15-99 years) during 2013-2015.
  • Funding: US Centers for Disease Control and Prevention Prescription Drug Overdose.

Key results

  • 4.0% of workers reported long-term opioid use.
  • Risk for long-term opioid use significantly increased with:
    • ≥20 days opioid supply vs ˂5 days’ supply (OR, 28.94; P<.001>
    • 5-9 vs
    • Number of prescribers visited within 90 days (≥3 vs 1: OR, 14.91; P<.001>
    • Long-acting vs short-acting prescription within 30 days (OR, 3.01; P<.001>
    • Overlapping opioid and benzodiazepine prescription within 30 days (OR, 1.38; P<.01>
    • ≥160 daily MME vs 40 MME within 30 days (OR, 3.24; P<.001>

Limitations

  • Observational study.

Coauthored with Antara Ghosh, PhD