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Work Enabling Opioid Management.

Robert A Lavin1, Nimisha Kalia, Larry Yuspeh

  • 1Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland (Dr Lavin); Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Kalia, Tao); Strategic Risk and Strategy Management, Louisiana Workers' Compensation Corporation, Baton Rouge, Louisiana (Mr Yuspeh); Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (Mr Yuspeh, Dr Bernacki); Workers' Compensation Department, Johns Hopkins Health System & Johns Hopkins University, Baltimore, Maryland (Ms Barry); Dell Medical School-The University of Texas at Austin, Austin, Texas (Dr Bernacki).

Journal of Occupational and Environmental Medicine
|July 11, 2017
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Summary
This summary is machine-generated.

Chronic opioid therapy (COT) did not prevent claimants from returning to work. Most patients on COT were released to work, demonstrating that appropriate prescribing aligns with work ability.

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Area of Science:

  • Occupational medicine
  • Pharmacology
  • Pain management

Background:

  • Opioid prescribing patterns significantly impact patient outcomes and return-to-work timelines.
  • Understanding the relationship between opioid therapy duration and work capacity is crucial for effective patient management and disability assessment.

Purpose of the Study:

  • To investigate the association between chronic opioid therapy (COT) and the ability to work among claimants.
  • To compare work release patterns between patients receiving short-term (acute opioid therapy; AOT) and long-term (COT) opioid treatment.

Main Methods:

  • A cohort of 4994 claimants was analyzed, categorizing them into COT (≥3 months), AOT (<3 months), or no opioid prescription groups.
  • Key variables included sex, age, daily morphine equivalent dose (MED), duration of opioid prescription, temporary total days (TTDs), and associated costs.
  • Statistical comparisons were made between the COT and AOT groups regarding opioid costs, TTDs, and average MED.

Main Results:

  • Claimants on COT incurred significantly higher opioid costs ($8618 vs $94) and experienced longer temporary total disability periods (636.2 vs 182.3 days) compared to AOT.
  • The average daily morphine equivalent dose (MED) was also higher in the COT group (66.8 vs 34.9).
  • Notably, only 2% of the COT cohort were not released to work, and 57% of patients in the COT category were released to work while still on opioid medication.

Conclusions:

  • Chronic opioid therapy, when managed within established guidelines, does not necessarily preclude an individual's ability to return to work.
  • These findings suggest that appropriate opioid prescribing practices can support, rather than hinder, vocational rehabilitation and return-to-work efforts.