Fulton-Kehoe Deborah, Haight John, Elmore Andrea, Sears Jeanne M, Wickizer Thomas, Franklin Gary M
Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
Am J Ind Med. 2025 Feb;68(2):132-139. doi: 10.1002/ajim.23683. Epub 2024 Dec 5.
Few studies have assessed long-term opioid prescribing after a work-related injury. There is limited information about opioid prescriptions before an injury and how receipt of opioids before a work injury is associated with long-term opioid prescribing. We present patterns of long-term opioid prescription among workers after an injury, overall, and by pre-injury opioid use.
We used linked workers' compensation and prescription drug monitoring program (PDMP) data to identify workers injured between July 2019 and June 2020 with an opioid prescription dispensed within 6 weeks after injury. Opioid prescribing was assessed for the 3 months before injury and for 1 year after injury or claim closure, whichever came first.
Among injured workers with an opioid in the first 6 weeks, 23% had opioids 6-12 weeks after injury, 19% had opioids 3-6 months, 14% had opioids 6-9 months, and 12% had opioids 9-12 months after injury; 19% had opioids in the 3 months before injury. For workers with opioid prescription prior to injury, the percentage with opioids 9-12 months after injury was 34%, versus 7% among workers with no opioids in the 3 months before injury (p < 0.001). Receipt of chronic opioids (for at least 60 days) 9-12 months after injury was substantially higher among those with prior opioid prescription (20%) than in those with no prior opioids (0.4%) (p < 0.001).
We found a strong relationship between opioid prescription in the 3 months before a work injury and opioid prescribing after an injury. Healthcare providers should be vigilant to the important relationship between prior opioid use and longer-term opioid use after work-related injuries.
很少有研究评估工伤后的长期阿片类药物处方情况。关于受伤前阿片类药物处方以及工伤前接受阿片类药物与长期阿片类药物处方之间的关联信息有限。我们呈现了受伤工人长期阿片类药物处方的模式，总体情况以及按受伤前阿片类药物使用情况分类的模式。
我们使用了关联的工人赔偿和处方药监测计划（PDMP）数据，以识别在2019年7月至2020年6月期间受伤且在受伤后6周内开具了阿片类药物处方的工人。对受伤前3个月以及受伤后1年或索赔结案（以先到者为准）的阿片类药物处方情况进行了评估。
在受伤后前6周内接受阿片类药物治疗的受伤工人中，23%在受伤后6 - 12周仍在使用阿片类药物，19%在3 - 6个月仍在使用，14%在6 - 9个月仍在使用，12%在9 - 12个月仍在使用；19%在受伤前3个月就已使用阿片类药物。对于受伤前有阿片类药物处方的工人，受伤后9 - 12个月仍在使用阿片类药物的比例为34%，而受伤前3个月未使用阿片类药物的工人这一比例为7%（p < 0.001）。受伤后9 - 12个月接受慢性阿片类药物治疗（至少60天）的比例，有阿片类药物处方史的工人（20%）显著高于无阿片类药物处方史的工人（0.4%）（p < 0.001）。
我们发现工伤前3个月的阿片类药物处方与受伤后的阿片类药物处方之间存在密切关系。医疗保健提供者应警惕工伤前使用阿片类药物与工伤后长期使用阿片类药物之间的重要关联。
