A new study reveals six factors that can lead to long-term opioid use for employees injured at work and who weren’t previously taking the prescription painkillers.
The strongest factor associated with long-term opioid use was receiving 20 or more days supply in their first prescription, followed by visiting three or more prescribers within 90 days of injury.
In the study of 46,399 Tennessee workers, 4% (1,843) began long-term opioid use after their workplace injury.
The other related factors are:
- receiving a long-acting opioid within 30 days of injury
- overlapping opioid and benzodiazepine prescription
- visiting three or more pharmacies within 90 days of injury, and
- receiving maximum dosage within 30 days of injury.
The study notes even just five to nine days’ supply of an opioid was associated with an increase in the odds of long-term use, compared with less than five days’ supply.
(The U.S. Centers for Disease Control and Prevention guidelines call for providing the lowest dose of a short-acting opioid for the fewest days possible – preferably three and no more than seven days.)
“Addressing injury as a gateway to long-term opioid use is an important step toward curbing the opioid epidemic,” the study states.
For injured workers, prescribing practices appear to be more closely linked with long-term opioid use than demographic characteristics (age, gender, race, etc.).
“Unlike patient demographic characteristics, prescribing may be modified to reduce patient risk,” the study concludes.
Of course, the study also points to one more solution for employers: Prevent employee injuries in the first place, removing the need for a prescription painkiller.
What else can employers do to reduce opioid usage among their employees?
- Discuss a limit on the number of pills on initial opioid prescriptions with your insurers, particularly workers’ comp
- Limit coverage of opioids to a network of pharmacies and providers
- Expand coverage for pain management alternatives, such as physical therapy, even if these options are initially more expensive
- Monitor workers’ comp claims to see if opioid prescriptions are being used as a low-cost option
- Provide employee training to increase awareness about opioid use, and
- Revisit and enhance your drug counseling programs.
The study, Prevalence and Risk Factors Associated with Long-term Opioid Use After Injury Among Previously Opioid-Free Workers, was published in JAMA Network Open.
