Early opioid prescription and risk of long-term opioid use among US workers with back and shoulder injuries

Posted on July 10, 2015 by Maurice Preter MD

Inj Prev doi:10.1136/injuryprev-2015-041630
  • Student submission

Early opioid prescription and risk of long-term opioid use among US workers with back and shoulder injuries: a retrospective cohort study

  1. Sara E Heins1,
  2. Dorianne R Feldman2,
  3. David Bodycombe1,
  4. Stephen T Wegener2,
  5. Renan C Castillo1

+Author Affiliations


  1. 1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

  2. 2Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  1. Correspondence toSara Heins, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 508, Baltimore, MD, USA; sheins2@jhu.edu
  • Received 26 March 2015
  • Revised 31 May 2015
  • Accepted 12 June 2015
  • Published Online First 1 July 2015

Abstract

The number of prescription opioid overdose deaths has increased dramatically in recent years and many prescribers are unsure how to balance treatment of pain with secondary prevention. Guidelines recommend low-severity injury patients not receive opioids early in the course of their care, but evidence supporting this guideline is limited. Data from 123 096 workers’ compensation claims with back and shoulder injuries were analysed to evaluate this guideline. Back and shoulder injury claimants with early opioid use (≤1 month after injury) had 33% lower (95% CI 24% to 41% lower) odds and 29% higher (95% CI 6% to 58% higher) odds, respectively, of long-term opioid use (>3 months) than claimants with late opioid use, after adjusting for key covariates. Stratified analyses indicate that early opioid use does not appear to increase the risk of long-term use except in cases where no diagnosis or only the diagnosis of unspecified shoulder pain is given prior to prescription.