WCRI finds opioid dispensing more prevalent in rural areas; small businesses

Liz Carey

Cambridge, MA (WorkersCompensation.com) – Injured workers in mining and construction, as well as workers employed at small firms and in rural counties, are more likely to receive prescriptions for opioids, a new study shows.

The study looked at worker age, injury, industry and location and how those characteristics impacted opioid prescription rates. Some injured workers, the study found, were more likely to receive prescriptions for opioids, as well as receive opioid prescriptions for longer periods of time and for higher doses. Additionally, the study found that workers residing in rural or very rural counties, workers at smaller firms and workers between the ages of 40 and 60, and workers who sustained fractures, carpel tunnel syndrome or neurological spine pain, were more likely to receive at least one opioid prescription.

The study looked at 1.4 million post-injury pain medication prescriptions in 27 states between October 1, 2014 and September 30, 2015. Those states included: Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Study author Dr. Vennela Thumula said in an interview with WorkersCompensation.com that the study looked at patterns WCRI had seen in previous studies.

“WCRI has been examining opioid utilization patterns across states and overtime for many years,” Thumla said. “Over these years we learned that workers in certain industries, workers sustaining certain injuries were more likely to receive opioids. This study was an attempt to quantify this variation.”

The study found that 62 percent of workers in the mining industry and 55 percent of those in the construction industry who were injured on the job and prescribed pain medication received a prescription for opioids. Of those, one third of the workers in mining and 29 percent of the workers in construction industry were found to have prescriptions to two or more opioids. More than 10 percent in both industries had prescriptions for 60 days or more.

The study found that 54 percent of injured workers who were employed by smaller firms (those making more than $4 million per year) were prescribed opioids, as opposed to 48 percent of those who worked for large firms (those making more than $80 million per year). Additionally, workers who lived in rural and very rural areas were more likely to receive an opioid prescription than those who lived in urban areas.

In general, Thumula said, opioid prescriptions are declining.

“In previous WCRI studies, we found substantial decreases in opioids dispensed to injured workers,” she said. “Also, fewer injured workers received opioids on a longer-term basis in recent years. We haven’t specifically examined whether workers had a diagnosis of opioid use disorders but a decrease in opioid prescriptions, especially on a longer-term basis may have impacted the rate of opioid dependency.”

While WCRI does not make any policy recommendations, the information may be of use to those who do, WCRI officials said.

“This study can help public officials and other stakeholders better predict which injured workers are more or less likely to receive opioids,” said Dr. John Ruser, WCRI’s president and CEO. “For example, this study finds that injured workers in certain industries are more likely to receive opioids on a chronic basis. This information might be useful in setting priorities for targeting special interventions to reduce inappropriate opioid prescriptions.”

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