RT Journal Article
SR Electronic
T1 Early opioid prescription and risk of long-term opioid use among US workers with back and shoulder injuries: a retrospective cohort study
JF Injury Prevention
JO Inj Prev
FD BMJ Publishing Group Ltd
SP 211
OP 215
DO 10.1136/injuryprev-2015-041630
VO 22
IS 3
A1 Sara E Heins
A1 Dorianne R Feldman
A1 David Bodycombe
A1 Stephen T Wegener
A1 Renan C Castillo
YR 2016
UL http://injuryprevention.bmj.com/content/22/3/211.abstract
AB 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.