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Opioid use and dosing in the workers' compensation setting. A comparative review and new data from Ohio
Allard Dembe1, Thomas Wickizer, Cynthia Sieck
1Division of Health Services Management & Policy,The Ohio State University College of Public Health, 1841 Neil Avenue,Columbus, OH 43210, USA. adembe@cph.osu.edu
Background:
Many authorities are concerned about the rising use and the potential overuse of opioid pain medications. A study of opioid prevalence and dosage in Ohio's workers' compensation (WC) system was conducted, with comparisons made to opioid use in other WC and non-WC settings.
Methods:
Systematic literature reviews of WC and non-WC opioid use and dosage nationally were conducted. Two years of Ohio WC data (2008-2009) were analyzed to determine average daily morphine equivalent dose (MED), opioid costs, pharmacies used per claimant, and extent of long-duration cases.
Results:
Nearly one-fifth (19.2%) of Ohio WC claims involved opioid use, compared to 31.8% in other WC systems and 17.9% in non-WC settings. Mean MED was 57.5 mg, compared to 47.8 mg in other WC systems, and 41.8 mg among non-WC populations. Nearly 10% of WC claims involved relatively high MED exceeding 120 mg/day.
Conclusion:
Policy makers need to develop strategies for addressing high opioid use in WC systems.
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