Bending the Prescription Opioid Dosing and Mortality Curves: Impact of the Washington State Opioid Dosing Guideline

Details

• Personal Author:
  Franklin GM ; Fulton-Kehoe D ; Mai J ; Sullivan M ; Turner J ; Wickizer T
• Description:
  Background: Opioid use and dosing for patients with chronic non-cancer pain have dramatically increased over the past decade, resulting in a national epidemic of mortality associated with unintentional overdose, and increased risk of disability among injured workers. We assessed changes in opioid dosing patterns and opioid-related mortality in the Washington State (WA) workers' compensation system following implementation of a specific WA opioid dosing guideline in April, 2007. Methods: Using detailed computerized billing data from WA workers' compensation, we report overall prevalence of opioid prescriptions, average morphine-equivalent dose (MED)/day, and proportion of workers on disability compensation receiving opioids and high-dose (>=120 mg/day MED) opioids over the past decade. We also report the trend of unintentional opioid deaths during the same time period. Results: Compared to before 2007, there has been a substantial decline in both the MED/day of long-acting DEA Schedule II opioids (by 27%) and the proportion of workers on doses >=120 md/day MED (by 35%). There was a 50% decrease from 2009 to 2010 in the number of deaths. Conclusions: The introduction in WA of an opioid dosing guideline appears to be associated temporally with a decline in the mean dose for long-acting opioids, percent of claimants receiving opioid doses >=120 mg MED per day, and number of opioid-related deaths among injured workers. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Drug Therapy Mortality Occupational Health Safety
• Keywords:
  Author Keywords: Chronic Pain Drug Therapy Guideline Medical Care Mortality Mortality Rates Opioids Population-based Prescription Drugs Workers' Compensation Workers Compensation

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 10 ; OSHA Region 5 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  325-331
• Volume:
  55
• Issue:
  4
• NIOSHTIC Number:
  nn:20056422
• Citation:
  Am J Ind Med 2012 Apr; 55(4):325-331
• Contact Point Address:
  Gary M. Franklin, MD, MPH, Research Professor, Department of Environmental and Occupational Health Sciences, University of Washington, 130 Nickerson Street, STE 212 Seattle,WA 98109
• Email:
  meddir@uw.edu
• Federal Fiscal Year:
  2012
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:123e8cfaefa920fa6e7902f86be6abb0d18397a60b2d8ea8523e4df20bfff528ce9ae0a44e6b40ee87dfd16bb37a4f721c48fa1eac91c27be7e7eb7145ceddd7
• Download URL:
  https://stacks.cdc.gov/view/cdc/214030/cdc_214030_DS1.pdf
• File Type:
  [PDF - 324.31 KB ]