Understanding the use and impact of early opioid prescriptions for work-related low-back pain
Reasons for the study
Prescription opioid use among workers with musculoskeletal disorders is a significant source of concern for the workers' compensation system. Prior studies suggest opioids prescribed shortly after a claim for low-back pain (LBP) can lead to prolonged work disability. However, these studies likely underestimated prescriptions, did not always distinguish exposure from outcome windows, and did not account for potential confounding factors, such as pre-injury health care and prescriptions, use of other therapies, and comorbidities. They also compared opioid users to non-users, the latter of which may include claimants who may differ in injury severity. The objective of this study is to address some of these limitations and provide further clarity on this important issue.
Objectives of the study
- To describe pre- and post-injury patterns of health care and LBP-relevant prescription dispensing and their associated factors
- To describe post-injury prescription dispensing patterns over time
- To assess the validity of workers’ compensation prescription billing data
- To describe post-claim opioid prescription patterns suggestive of possible opioid misuse or problematic prescribing
- To determine if prescription opioids dispensed within the first eight weeks of filing a new workers' compensation lost-time claim for LBP are associated with future work disability compared to nonsteroidal anti-inflammatory drugs or muscle relaxants
These findings may help inform new and existing policies in workers’ compensation systems. They may also be relevant to physicians with respect to clinical practice patterns.
Related scientific publications
Canadian Institutes of Health Research, WorkSafeBC