Longer-Term Opioid Use Among Injured Workers Decreased In Several States, Says New WCRI Study

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The study, Longer-Term Use of Opioids, 3rd Edition, examines the prevalence and trends of longer-term use of opioids in 25 states and how often the services recommended by medical treatment guidelines were used for monitoring and managing chronic opioid therapy.

Sample chart from study.

Sample chart from study.

There is little quality evidence about the benefits of long-term opioid use for chronic noncancer pain. Moreover, research finds that high doses and prolonged use of opioids may lead to addiction, increased disability, work loss, and even death.

Longer-term use of opioids among injured workers decreased in a number of states, according to a new study by the Workers Compensation Research Institute (WCRI). The study looked at longer-term opioid use over a two-year time period ending March 2014 and compared that with longer-term use over the two-year time period ending March 2012.

“There is little quality evidence about the benefits of long-term opioid use for chronic noncancer pain. Moreover, research finds that high doses and prolonged use of opioids may lead to addiction, increased disability, work loss, and even death,” said Dongchun Wang, the author of the study.

The study, Longer-Term Use of Opioids, 3rd Edition, examines the prevalence and trends of longer-term use of opioids in 25 states and how often the services recommended by medical treatment guidelines were used for monitoring and managing chronic opioid therapy.

The following are among the study’s major findings:

  •     The frequency of claims that received opioids on a longer-term basis decreased more than 2 percentage points in Michigan over the study period, which translates to an approximately 31 percent reduction. The same measure decreased 1–2 percentage points in several other states (Maryland, New Jersey, New York, North Carolina, and Texas).
  •     Although longer-term opioid use increased in Wisconsin and Indiana, the frequency of longer-term use was lower compared with the other study states.
  •     In the roughly two-year time period ending March 2014, longer-term opioid use was most prevalent in Louisiana—1 in 6 injured workers with opioids was identified as having longer-term use of opioids. Compared with most study states, the number was also higher in California, New York, and Pennsylvania. Missouri and New Jersey had the lowest rate among the study states.
  •     While the percentage of injured workers with longer-term use of opioids receiving drug testing was lower than recommended by treatment guidelines, the frequency of drug tests was unusually high among the top 5 percent of injured workers who received opioids on a longer-term basis and had drug testing.
  •     In most states, few injured workers with longer-term opioid use received psychological evaluations and psychological treatment. Even in Texas, the state with the highest use of these services, about 1 in 3 had a psychological evaluation and 1 in 8 received psychological treatment.

This study uses data comprising over 300,000 nonsurgical workers’ compensation claims with more than seven days of lost time and over 1 million prescriptions associated with these claims from 25 states. The study is focused on two time periods, with the latest period covering claims with injuries arising from October 1, 2011, to September 30, 2012, with prescriptions filled through March 31, 2014. 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 http://www.wcrinet.org/studies/public/books/longer_term_use_of_opioids3_book.html.

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

ABOUT WCRI:

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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