Early Opioid Prescription and Subsequent Disability Among Workers with Back Injuries: The Disability Risk Identification Study Cohort

Details

• Personal Author:
  Franklin GM ; Fulton-Kehoe D ; Stover BD ; Turner JA ; Wickizer TM
• Description:
  STUDY DESIGN: Prospective, population-based cohort study. OBJECTIVE: To examine whether prescription of opioids within 6 weeks of low back injury is associated with work disability at 1 year. SUMMARY OF BACKGROUND DATA: Factors related to early medical treatment have been little investigated as possible risk factors for development of long-term work disability among workers with back injuries. We have previously shown that about 1 of 3 of workers receive an opioid prescription early after a low back injury, and a recent study suggested that such prescriptions may increase risk for subsequent disability. METHODS: We analyzed detailed data reflecting paid bills for opioids prescribed within 6 weeks of the first medical visit for a back injury among 1843 workers with lost work-time claims. Additional baseline measures included an injury severity rating from medical records, and demographic, psychosocial, pain, function, smoking, and alcohol measures from a worker survey conducted 18 days (median) after receipt of the back injury claim. Computerized database records of work disability 1 year after claim submission were obtained for the primary outcome measure. RESULTS: Nearly 14% (254 of 1843) of the sample were receiving work disability compensation at 1 year. More than one-third of the workers (630 of 1843) received an opioid prescription within 6 weeks, and 50.7% of these (319 of 630) were received at the first medical visit. After adjustment for pain, function, injury severity, and other baseline covariates, receipt of opioids for more than 7 days (odds ratio = 2.2; 95% confidence interval, 1.5-3.1) and receipt of more than 1 opioid prescription were associated significantly with work disability at 1 year. CONCLUSION: Prescription of opioids for more than 7 days for workers with acute back injuries is a risk factor for long-term disability. Further research is needed to elucidate this association. [Description provided by NIOSH]
• Subjects:
  Demography Drug Therapy Musculoskeletal Diseases Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Back-injuries Demographic-characteristics Disabled-workers Drug-interaction Drug-therapy Injuries Pain-tolerance Risk-analysis Risk-factors Traumatic-injuries Work-capability Work-performance Worker-health Workers

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• ISSN:
  0362-2436
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  199-204
• Volume:
  33
• Issue:
  2
• NIOSHTIC Number:
  nn:20033146
• Citation:
  Spine 2008 Jan; 33(2):199-204
• Contact Point Address:
  Gary M. Franklin, MD, MPH, Department of Environmental and Occupational Health Sciences, University of Washington, 1914 N. 34th Street, 101, Seattle, WA 98103
• Email:
  meddir@u.washington.edu
• Federal Fiscal Year:
  2008
• Performing Organization:
  University of Washington
• Peer Reviewed:
  False
• Start Date:
  20010930
• Source Full Name:
  Spine
• End Date:
  20070929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:05654996154ff380a184e4496f8f5abbdfed0bdaf83c470a3da014fba8a59ae63305cb10c21db641f47fc85fdb703c70bc12a4b38eba05f64c0dd6cdf6abdfb4
• Download URL:
  https://stacks.cdc.gov/view/cdc/188832/cdc_188832_DS1.pdf
• File Type:
  [PDF - 256.10 KB ]