• Gary M Franklin, Jaymie Mai, Judith Turner, Mark Sullivan, Thomas Wickizer, and Deborah Fulton-Kehoe.
• Departments of Environmental and Occupational Health Sciences, Neurology, and Health Services, University of Washington School of Public Health, Seattle, WA 98109, USA. meddir@uw.edu
• Am. J. Ind. Med. 2012 Apr 1;55(4):325-31.

BackgroundOpioid use and dosing for patients with chronic non-cancer pain have dramatically increased over the past decade, resulting in a national epidemic of mortality associated with unintentional overdose, and increased risk of disability among injured workers. We assessed changes in opioid dosing patterns and opioid-related mortality in the Washington State (WA) workers' compensation system following implementation of a specific WA opioid dosing guideline in April, 2007.MethodsUsing detailed computerized billing data from WA workers' compensation, we report overall prevalence of opioid prescriptions, average morphine-equivalent dose (MED)/day, and proportion of workers on disability compensation receiving opioids and high-dose (≥120 mg/day MED) opioids over the past decade. We also report the trend of unintentional opioid deaths during the same time period.ResultsCompared to before 2007, there has been a substantial decline in both the MED/day of long-acting DEA Schedule II opioids (by 27%) and the proportion of workers on doses ≥120 md/day MED (by 35%). There was a 50% decrease from 2009 to 2010 in the number of deaths.ConclusionsThe introduction in WA of an opioid dosing guideline appears to be associated temporally with a decline in the mean dose for long-acting opioids, percent of claimants receiving opioid doses ≥120 mg MED per day, and number of opioid-related deaths among injured workers.Copyright © 2011 Wiley Periodicals, Inc.

19 keywords...

hide…