Costs and Work Loss Burden of Diagnosed Opioid Abuse Among Employees on Workers Compensation or Short-term Disability

Johnston, Stephen S.; Alexander, A.; Masters, Elizabeth T.; Mardekian, Jack; Semel, David; Malangone-Monaco, Elisabetta; Riehle, Ellen; Wilson, Kathleen; Sadosky, Alesia

doi:10.1097/jom.0000000000000865

Cited by 10 publications

(18 citation statements)

References 13 publications

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“…Two studies reported data on annual inpatient stays over a 12-month follow-up period; the average number of annual inpatient stays was 0.8–1.9 for abusers and 0.1–1.3 for controls, respectively [ 34 , 35 ]. These studies similarly reported that abusers had a significantly higher average number of hospitalization days over a 12-month follow-up period when compared with controls (4.8 and 10.6 days for abusers and 0.5 and 5.2 days for non-abusers, respectively) [ 34 , 35 ]. In addition, the average number of mental health-related hospitalization days during the same period was significantly greater for abusers compared with controls (3.2 vs 0.0; p < 0.0001) [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported the proportion of abusers with 1 or more inpatient visits during a 12-month follow-up period following diagnosis, which varied from 34.2 to 57.7% for abusers and 7.3 to 25.5% for controls [ 24 , 34 ]. The average proportion of patients with an inpatient visit was highest among Medicare members aged < 65 years (43.3%), compared to privately insured US patients (40.2%) and Medicare members aged ≥ 65 years (34.2%) [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…The average proportion of patients with an inpatient visit was highest among Medicare members aged < 65 years (43.3%), compared to privately insured US patients (40.2%) and Medicare members aged ≥ 65 years (34.2%) [ 24 ]. Among abusers with a claim for workers’ compensation, the proportion with an inpatient visit was 57.7% [ 34 ]. A separate study reported the average number of inpatient stays per-patient-per-month for abusers and controls; results showed that abusers had a significantly higher average number of inpatient stays compared with controls during both the pre- and post-index periods ( p <0.0001) [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Included studies reported ED utilization as the proportion of patients with 1 or more ED visit, the average number of ED visits, or ED days over a 6- or 12-month follow-up period [ 19 , 20 , 24 , 34 , 35 , 37 , 38 ]. Due to inconsistencies in follow-up period length and outcome measurements, it is difficult to draw direct comparisons between these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Several included studies reported pharmacy utilization as the average number of opioid days supplied, opioid units dispensed, outpatient pharmacy prescriptions, and prescription fills (including opioid and non-opioid fills). Generally, abusers demonstrated significantly higher levels of pharmacy utilization across all categories compared with non-abusers [ 19 , 20 , 34 , 35 , 37 ]. A 12-month analysis from 2 similar studies of different claims databases demonstrated that the abuser cohort had an average of 31.6 and 36.0 prescription fills compared with 22.4 and 29.2 prescription fills in the non-abuser group (the difference between abuser and non-abuser cohorts for both studies was reported to be statistically significant, with p < 0.001) [ 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

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The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

Reinhart

Scarpati

Kirson

et al. 2018

Appl Health Econ Health Policy

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BackgroundAbuse of prescription opioids [opioid use disorder (OUD), poisoning, and fatal and non-fatal overdose] is a public health and economic challenge that is associated with considerable morbidity and mortality in the USA and globally.ObjectiveTo systematically review and summarize the health economics literature published over the last 5 years that describes the economic burden of abuse of prescription opioids.MethodsFindings from searches of databases including MEDLINE, Embase, and Cochrane CENTRAL as well as hand searches of multiple conference abstracts were screened against predefined inclusion criteria to identify studies reporting cost and healthcare resource utilization (HRU) data associated with abuse of prescription opioids.ResultsA total of 49 unique studies were identified. Most of the studies examined direct costs and HRU, which were substantially higher for abusers of prescription opioids than non-abuser controls in several matched cohort analyses (US$20,343–US$28,718 vs US$9716–US$14,079 for mean direct combined annual healthcare costs reported in 6 studies). Although only a small number of studies reported indirect costs, these findings suggest a high societal burden related to productivity losses, absenteeism, morbidity, and mortality among those who abuse opioids. Studies of medication-assisted treatment demonstrated that factors such as adherence, dose, formulation (film or tablet), and relapse during treatment, were associated with direct costs and HRU among treated patients.ConclusionsThis systematic literature review shows that abuse of prescription opioids is characterized by substantial direct healthcare costs, medical utilization, and related societal costs. Future research should further investigate the indirect costs of opioid abuse.Electronic supplementary materialThe online version of this article (10.1007/s40258-018-0402-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

Reinhart

Scarpati

Kirson

et al. 2018

Appl Health Econ Health Policy

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Prevalence and Risk Factors Associated With Long-term Opioid Use After Injury Among Previously Opioid-Free Workers

et al. 2019

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IMPORTANCE Using opioids for acute pain can lead to long-term use and associated morbidity and mortality. Injury has been documented as a gateway to long-term opioid use in some populations, but data are limited for injured workers. OBJECTIVE To evaluate the prevalence and risk factors of long-term opioid use after injury among workers in Tennessee who were opioid free at the time of injury. DESIGN, SETTING, AND PARTICIPANTS This cohort study identified injured workers aged 15 to 99 years who reported only 1 injury to the Tennessee Bureau of Workers' Compensation from March 2013 to December 2015 and had no opioid prescription in the 60 days before injury. Participants were matched to their prescription history in Tennessee's prescription drug monitoring program. Analysis was conducted from November 2017 to March 2018. Logistic regression models were used to calculate adjusted odds ratios (ORs) and 95% CIs for associations of demographic, injury, and opioid use variables with long-term use. MAIN OUTCOMES AND MEASURES The primary outcome was long-term opioid use, defined as having an opioid supplied for 45 or more days in the 90 days after injury. RESULTS Among 58 278 injured workers who received opioids after injury (18 977 [32.5%] aged 15-34 years, 27 514 [47.2%] aged 35-54 years, and 11 787 [20.2%] aged 55-99 years; 32 607 [56.0%] men), 46 399 (79.6%) were opioid free at the time of injury. Among opioid-free injured workers, 1843 (4.0%) began long-term opioid use. After controlling for covariates, long-term use was associated with receiving 20 or more days' supply in the initial opioid prescription compared with receiving less than 5 days' supply (OR, 28.94; 95% CI, 23.44-35.72) and visiting 3 or more prescribers in the 90 days after injury compared with visiting 1 prescriber (OR, 14.91; 95% CI, 12.15-18.29). However, even just 5 days' to 9 days' supply was associated with an increase in the odds of long-term use compared with less than 5 days' supply (OR, 1.83; 95% CI, 1.56-2.14). CONCLUSIONS AND RELEVANCE In this study of injured workers, injury was associated with longterm opioid use. The number of days' supply of the initial opioid prescription was the strongest risk factor of developing long-term use, highlighting the importance of careful prescribing for initial opioid prescriptions.

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Impact of Prescription Medicines on Work-Related Outcomes in Workers with Musculoskeletal Disorders or Injuries: A Systematic Scoping Review

Tefera,

Gray,

Nielsen

et al. 2023

J Occup Rehabil

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Purpose Medicines are often prescribed to workers with musculoskeletal disorders (MSDs) and injuries to relieve pain and facilitate their recovery and return to work. However, there is a growing concern that prescription medicines may have adverse effects on work function. This scoping review aimed to summarize the existing empirical evidence on prescription medicine use by workers with MSD or injury and its relationship with work-related outcomes. Methods We identified studies through structured searching of MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Scopus, Web of Science and Cochrane library databases, and via searching of dissertations, theses, and grey literature databases. Studies that examined the association between prescription medicine and work-related outcomes in working age people with injury or MSDs, and were published in English after the year 2000 were eligible. Results From the 4884 records identified, 65 studies were included for review. Back disorders and opioids were the most commonly studied musculoskeletal conditions and prescription medicines, respectively. Most studies showed a negative relationship between prescription medicines and work outcomes. Opioids, psychotropics and their combination were the most common medicines associated with adverse work outcomes. Opioid prescriptions with early initiation, long-term use, strong and/or high dose and extended pre- and post-operative use in workers’ compensation setting were consistently associated with adverse work function. We found emerging but inconsistent evidence that skeletal muscle relaxants and non-steroidal anti-inflammatory drugs were associated with unfavorable work outcomes. Conclusion Opioids and other prescription medicines might be associated with adverse work outcomes. However, the evidence is conflicting and there were relatively fewer studies on non-opioid medicines. Further studies with more robust design are required to enable more definitive exploration of causal relationships and settle inconsistent evidence.

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Costs and Work Loss Burden of Diagnosed Opioid Abuse Among Employees on Workers Compensation or Short-term Disability

Abstract: Opioids are commonly prescribed to employees with injury-related WC/STD claims. Employers may benefit from proactively addressing the issue of opioid abuse in these populations.

Cited by 10 publications

References 13 publications

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

Prevalence and Risk Factors Associated With Long-term Opioid Use After Injury Among Previously Opioid-Free Workers

Impact of Prescription Medicines on Work-Related Outcomes in Workers with Musculoskeletal Disorders or Injuries: A Systematic Scoping Review

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