The Department of Health and Human Services declared a public health emergency on October 26, 2017 in response to the nationwide opioid crisis. To put it into perspective: in 2016, 116 Americans died every day from opioid-related drug overdose – that’s one person every 12.5 minutes. More than 11.5 million people admitted to misusing prescription opioids, and more than 80 percent of injection drug users admitted to abusing opioid pain relievers prior to heroin. And costs to treat the epidemic are staggering, estimated at over $500 billion.
“It’s clear that opioids have done a lot of harm. But they potentially have some medical value via pain reduction,” says David Neumark, UCI Chancellor’s professor of economics and labor economics expert. “The question is whether they have provided benefits for injured workers, enabling them to get back to work faster. And the short answer is no.”
Neumark, who is also director of the UCI Economic Self Sufficiency Policy Research Institute and a senior research fellow at the Workers Compensation Research Institute (WCRI), teamed with co-authors at WCRI to assess the impact of opioids, in the workers’ compensation system, on the duration of temporary disability, during which workers receive benefits before - in most cases – returning to work.
They specifically looked at local prescribing patterns - which have a strong relationship with whether injured workers receive opioid prescriptions - for workers with lower back injuries.
These cases represent anywhere from 11-19 percent of workers’ compensation claims with more than seven days of lost time, says Neumark, and opioids are more commonly prescribed for low back pain claims than in most other injury groups.
Information for the study came from the Workers Compensation Research Institute Detailed Benchmark/Evaluation database, spanned five years (Oct 2008-Sept 13) and covered 28 states representing over 80 percent of benefits paid.
They found that longer-term opioid prescribing leads to considerably longer duration of temporary disability.
“Opioid use is common among workers injured at work,” says Neumark. “Studies have shown that more than half of injured workers off work for more than a week with pain medications who did not have surgery received an opioid prescription, and many of them received opioids on a longer-term basis. However, given the risks from opioids, this research makes it hard to identify a ‘positive’ associated with their prescription.”
With respect to returning injured employees to work, Neumark points to the study results as a rationale for policies that try to restrict long-term use of opioids that are not medically indicated.
Coauthors included Bogdan Savych, researcher at the Workers Compensation Research Institute, and Randall Lea, Chief Medical Officer at Alice Peck Day Memorial Hospital (New Hampshire), and also a senior fellow at the Workers Compensation Research Institute. Funding for this work was provided by the Workers Compensation Research Institute, which does non-partisan research on workers’ compensation with a rigorous peer and technical review system.
The full study, The Impact of Opioid Prescriptions on Duration of Temporary Disability, can be downloaded online.
*Statistics obtained online at the Department of Health and Human Services and NIH National Institute on Drug Abuse.
-Heather Ashbach, UCI School of Social Sciences