Long-term opioid use significantly delays return to work, workers’ comp study shows

Cambridge, MA — A Workers Compensation Research Institute study of workers with low-back injuries shows those who receive longer-term prescriptions for opioid painkillers take significantly longer to return to work than those who are not prescribed opioids.

The researchers defined longer-term prescriptions as those given within the first three months after an injury with at least three prescriptions filled between the seventh and 12th months after the same injury.

For the study, the researchers looked at payment information on five years’ worth of workers’ compensation claims in WCRI’s Detailed Benchmark/Evaluation database, which covers 28 states. The data includes information on workers, employers, injury characteristics, opioid prescription patterns and duration of temporary disability benefits, based on payments made within 24 months after an injury.

The study focused on cases of low-back injury pain in which the worker was away from work for more than seven days. Results showed that workers who had longer-term opioid prescriptions received temporary disability benefits 251 percent longer than workers treated for low-back injuries without opioid prescriptions.

Treatment guidelines recommend against long-term opioid use for non-surgical low back pain, the study notes.

“Since longer-term opioids lead to longer duration of temporary disability benefits, it is important to understand the reasons why workers are receiving opioids on a longer-term basis so that policy interventions can be targeted toward reducing inappropriate longer-term use,” the researchers said.

They also found that where a worker lived played a role in whether he or she received a longer-term opioid prescription.

“For example, our results imply that a 10 percentage-point increase in the local rate of longer-term opioid prescribing is associated with a 2.6 percentage-point higher likelihood that an otherwise similar injured worker would receive longer-term opioid prescriptions,” the study authors wrote.

The researchers call for additional research on whether current policies aimed at reducing opioid prescribing are effective and could potentially “speed up” return to work.