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Dose Escalations Among Workers' Compensation Claimants Using Opioid Medications-An 8 Year Postinjury Follow up Study
Robert A Lavin1, Larry Yuspeh, Nimisha Kalia
1From the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (R.A.L., L.Y., N.K., N.F.T., N.L., E.J.B., X.G.T.); Strategy, Enterprise Risk, and Research, Louisiana Workers' Compensation Corporation, Baton Rouge, Louisiana (L.Y.); Texas Mutual, Workers' Compensation Insurance, Austin, Texas (N.F.T., N.L.); General Electric, Norwalk, Connecticut (N.K.); Corporate Administration Office, AF Group, Lansing, Michigan (D.L.H.); and University of Pennsylvania, Perelman School of Medicine, Division of Occupational Medicine, Philadelphia, Pennsylvania (J.G.-M.).
Objective:
The aim of the study is to determine the morphine equivalent dose in milligrams (MED)/day escalation trend after initial utilization.
Methods:
A total of 25,108 lost time claims filed between 1998 and 2007 were followed for 8 years from injury date. Claims were stratified by initial MED/day at 3 months after injury into four groups (0, 1 to < 15, 15 to < 30, and ≥30 MED/day). The slopes in MED/year of opioid dose escalation were determined for each initial MED/day group.
Results:
The slopes of MED/day escalation by initial MED categories were similar ( P ≥ 0.05) ranging from 5.38 to 7.76 MED annually. On average, MED/day increased in a liner pattern with a slope at 6.28 MED/year ( P < 0.01).
Conclusions:
Opioid MED/day increased in a linear pattern, regardless of initial MED/day dose.
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