Pharmacy Daily | Concerns over workers’ comp opioid use

THOUSANDS of injured Victorian employees are receiving high-risk opioid prescriptions funded by the Victorian workers' compensation system, according to research led by Monash University.

The study looked at opioid prescriptions for injured employees and measured the number with early high-risk prescribing patterns, defined as a large volume prescribed within the first three months, long-acting opioids prescribed early, or other high-risk medicines being prescribed at the same time.

The data was based on around 30,000 employees with back and neck injuries between 2010 to 2019, who had time off work due to their injury and made a workers' compensation claim.

Of these, around 20% were prescribed opioids in the first three months of their claim.

It is generally recommended to avoid opioids if possible and use other pain relief methods first, and if opioids are prescribed, they should be used for a short time and in low doses.

Among those prescribed opioids in the first three months, two out of three workers (67%) had early high-risk opioid prescriptions, and nearly one in four (23%) continued using opioids after a year.

"We found that early high-risk prescribing doubled the chances of long-term opioid use," said first author Yonas Tefera, from Monash University's School of Public Health and Preventive Medicine Healthy Working Lives Research Group.

"Previous studies show that injured workers who use opioids early or for a long time tend to have more time off work and worse health outcomes."

The study also found that workers in rural and more economically disadvantaged areas were more likely to receive early high-risk opioid prescriptions and also to have long-term use.

Senior author Professor Alex Collie said the results highlighted the extent of two potentially very harmful patterns among workers with common workplace injuries and compensation claims - early high-risk opioid prescribing and long-term opioid use.

"More than 120,000 Australians have workers' compensation claims involving more than a week off work every year, and many of these claims are for back and neck injuries," Professor Collie said.

"If the patterns we observe in Victoria also occur in other states and territories, then potentially thousands of workers are receiving high-risk opioid prescriptions funded by our workers' compensation systems," he said.

The study highlights the need for stronger monitoring of prescription patterns in our workers' compensation systems - however, most workers' comp regulators in Australia do not routinely capture data on prescription medicines.

Read the paper HERE. KB