Workers' compensation prescription medication patterns and associated outcomes

Area of Science:

• Occupational health
• Pain management
• Public health

Background:

• Opioid use for musculoskeletal injuries presents a complex risk-benefit balance.
• Higher opioid doses correlate with adverse health outcomes.
• Previous research indicates a link between opioid dosage and negative health effects.

Purpose of the Study:

• To investigate the association between opioid prescriptions and increased costs and deaths.
• To determine if opioid prescriptions contribute to costs and mortality through injury or direct effects.

Main Methods:

• Analysis of 144,553 Ohio Bureau of Workers' Compensation claims (2010-2016) for shoulder, knee, and low back injuries.
• Claims classified by affected body areas and injury severity (simple/complex).
• Outcome variables included costs, lost days, maximum opioid dose (MaxMED), and death status; logistic regression used for dose-death association.

Main Results:

• Significant associations found between MaxMED and medical/indemnity costs, and claimant death likelihood.
• These associations persisted across most claim types after adjusting for covariates.
• The link between increased opioid doses and deaths was observed even for low-severity injuries.

Conclusions:

• The association between higher opioid doses and mortality in low-severity injuries is concerning due to limited opioid efficacy for minor injuries.
• Recommendations include enhanced provider education, increased non-opioid utilization, and early intervention for soft-tissue injuries.
• These strategies may reduce claims costs, disability, and fatalities.