Association Between Pre-Injury Opioid Use and Opioid Use Patterns After a Work Injury

Few studies have assessed long-term opioid prescribing after a work-related injury. There is limited information about opioid prescriptions before an injury and how receipt of opioids before a work injury is associated with long-term opioid prescribing. We present patterns of long-term opioid prescription among workers after an injury, overall, and by pre-injury opioid use.

We used linked workers' compensation and prescription drug monitoring program (PDMP) data to identify workers injured between July 2019 and June 2020 with an opioid prescription dispensed within 6 weeks after injury. Opioid prescribing was assessed for the 3 months before injury and for 1 year after injury or claim closure, whichever came first.

Among injured workers with an opioid in the first 6 weeks, 23% had opioids 6-12 weeks after injury, 19% had opioids 3-6 months, 14% had opioids 6-9 months, and 12% had opioids 9-12 months after injury; 19% had opioids in the 3 months before injury. For workers with opioid prescription prior to injury, the percentage with opioids 9-12 months after injury was 34%, versus 7% among workers with no opioids in the 3 months before injury (p < 0.001). Receipt of chronic opioids (for at least 60 days) 9-12 months after injury was substantially higher among those with prior opioid prescription (20%) than in those with no prior opioids (0.4%) (p < 0.001).

We found a strong relationship between opioid prescription in the 3 months before a work injury and opioid prescribing after an injury. Healthcare providers should be vigilant to the important relationship between prior opioid use and longer-term opioid use after work-related injuries.