• Vivian H Lyons, Miriam J Haviland, Irene Y Zhang, Lauren K Whiteside, Saman Arbabi, Monica S Vavilala, Michele Curatolo, Frederick P Rivara, and Ali Rowhani-Rahbar.
• Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan; Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, School of Public Health, University of Washington, Seattle, Washington.
• J Emerg Med. 2022 Aug 1; 63 (2): 178191178-191.

BackgroundPatients with injury may be at high risk of long-term opioid use due to the specific features of injury (e.g., injury severity), as well as patient, treatment, and provider characteristics that may influence their injury-related pain management.ObjectivesInform prescribing practices and identify high-risk populations through studying chronic prescription opioid use in the trauma population.MethodsUsing the Washington State All-Payer Claims Database (WA-APCD) data, we included adults aged 18-65 years with an incident injury from October 1, 2015-December 31, 2017. We compared patient, injury, treatment, and provider characteristics by whether or not the patients had long-term (≥ 90 days continuous prescription opioid use), or no opioid use after injury.ResultsWe identified 191,130 patients who met eligibility criteria and were included in our cohort; 5822 met criteria for long-term use. Most had minor injuries, with a median Injury Severity Score = 1, with no difference between groups. Almost all patients with long-term opioid use had filled an opioid prescription in the year prior to their injury (95.3%), vs. 31.3% in the no-use group (p < 0.001). Comorbidities associated with chronic pain, mental health, and substance use conditions were more common in the long-term than the no-use group.ConclusionAcross this large cohort of multiple, mostly minor, injury types, long-term opioid use was relatively uncommon, but almost all patients with chronic use post injury had preinjury opioid use. Long-term opioid use after injury may be more closely tied to preinjury chronic pain and pain management than acute care pain management.Copyright © 2022. Published by Elsevier Inc.

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