Large Decreases in Opioids Received by Injured Workers Seen in Several States, Finds New WCRI Study

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This new drug study from WCRI observed a big decrease in the amount of opioids prescribed to injured workers in a majority of study states, which coincided with reforms directed at opioid use.

Sample chart from study.

Sample chart from study.

This information should be useful for state officials, payors and managed care companies, injured workers and worker advocates, and providers.

A new study by the Workers Compensation Research Institute (WCRI) observed noticeable decreases in the amount of opioids prescribed per workers’ compensation claim in a majority of study states, coinciding with reforms directed at opioid use.

The study, Interstate Variations in Use of Opioids, 3rd Edition, examines interstate variations and trends in the use of opioids and prescribing patterns of pain medications across 25 states. The study compares the amount of opioids prescribed per claim over two roughly 24-month periods of time ending March 2012 and March 2014.

According to the study, the amount of opioids received by injured workers decreased over the two time periods in the majority of the study states. Statistically significant reductions in the range of 20 to 31 percent were seen in Maryland, Massachusetts, Michigan, Oklahoma, North Carolina, and Texas.

Some of the study’s other findings are as follows:

  •     Opioid use was prevalent among nonsurgical claims with more than seven days of lost time. About 65 to 80 percent of these injured workers with pain medications received opioids in most states.
  •     Among claims with opioids, the average amounts of opioids received by injured workers in Louisiana, New York, and Pennsylvania were the highest among the 25 study states. Although Wisconsin, Iowa, and Missouri had an increase in the average amount of opioids per claim over the study period, they had a lower amount of opioids per claim than the median state at the end of the study period.
  •     Among claims with opioids, simultaneous use of opioids and benzodiazepines was seen in 1–9 percent of injured workers across the 25 states. Use of both opioids and muscle relaxants at the same time was seen in 30–45 percent of claims.

“This information should be useful for (1) state officials who wonder if the use of opioids is unusual in their state, (2) payors and managed care companies looking to set priorities for targeting opioid management programs, (3) injured workers and worker advocates looking to understand the extent of the problem in their state, and (4) providers who wonder what the prescribing norms in their state may be and if the state norms are unusual,” said Dr. Vennela Thumula, an author of the study and a policy analyst at WCRI.

This study uses data comprising over 337,000 nonsurgical workers’ compensation claims and nearly 1.9 million prescriptions associated with those claims from 25 states. The claims represent injuries arising from October 1, 2009, to September 30, 2012, with prescriptions filled through March 31, 2014. The underlying data reflect an average 24 months of experience for each claim. The data included in this study represent 40–75 percent of workers’ compensation claims in each state.

The 25 states in the study are Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

To purchase this study, visit WCRI’s website at

The Cambridge-based WCRI is recognized as a leader in providing high-quality, objective information about public policy issues involving workers' compensation systems.


The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Andrew Kenneally
Workers Compensation Research Institute - WCRI
since: 06/2011
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