Changes in Opioid Prescribing for Washington Workers’ Compensation Claimants After Implementation of an Opioid Dosing Guideline for Chronic Noncancer Pain: 2004 to 2010

Details

• Personal Author:
  Bauer AM ; Franklin GM ; Fulton-Kehoe D ; Garg RK ; Sullivan MD ; Turner JA ; Wickizer T
• Description:
  An opioid overdose epidemic emerged in the United States following increased opioid prescribing for chronic noncancer pain. In 2007, Washington State agencies implemented an opioid dosing guideline on safe prescribing for chronic noncancer pain. The objective of this population-based observational study was to evaluate opioid use and dosing before and after guideline implementation. We identified 161,283 workers aged 18 to 64 years with >=1 opioid prescriptions in Washington Workers' Compensation, April 1, 2004, to December 31, 2010. Prevalence and incidence rates of opioid use were assessed. We compared pre- and postguideline chronic and high-dose use (>=120 mg/d) among incident users. The mean monthly prevalence of opioid use declined by 25.6% between 2004 (14.4%) and 2010 (10.7%). Fewer incident users went on to chronic opioid therapy in the postguideline period (4.7%; 95% confidence interval [CI], 4.5-5.0%) than in the preguideline period (6.3%; 95% CI, 6.1-6.6%). Compared with preguideline incident users, postguideline incident users were 35% less likely to receive high doses (adjusted odds ratio = .65; 95% CI, .59-.71). Although the extent to which decreases were due to the guidelines is uncertain, to our knowledge, this is the first report of significant decreases in chronic and high-dose prescription opioid use among incident users. [Description provided by NIOSH]
• Subjects:
  Drug Therapy Morbidity Occupational Health Safety
• Keywords:
  Author Keywords: Opioids Chronic Pain Dosing Drug Therapy Guideline Guidelines Morbidity Rates Prescription Drugs Trends Workers Compensation
• ISSN:
  1526-5900
• 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
• Volume:
  14
• Issue:
  12
• NIOSHTIC Number:
  nn:20056435
• Citation:
  J Pain 2013 Dec; 14(12):1620-1628
• Contact Point Address:
  Renu K. Garg, MPH, Department of Epidemiology, University of Washington, 130 Nickerson St, Suite 212, Seattle, WA 98109
• Email:
  rkgarg@uw.edu
• Federal Fiscal Year:
  2014
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  The Journal of Pain
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7b6185e097a1bb978a44913489b9741b66f162dbf873b485fab51186995edcbfecf6fcddac59e4182c406ccafea098f53a24b7d8b464989af6365e451a4dfac1
• Download URL:
  https://stacks.cdc.gov/view/cdc/214041/cdc_214041_DS1.pdf
• File Type:
  [PDF - 588.63 KB ]