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Increases in the Use and Cost of Opioids to Treat Acute and Chronic Pain in Injured Workers, 1999 to 2009

Bernacki, Edward J. MD, MPH; Yuspeh, Larry BA; Lavin, Robert MD, MS; Tao, Xuguang (Grant) MD, PhD

Journal of Occupational and Environmental Medicine: February 2012 - Volume 54 - Issue 2 - p 216–223
doi: 10.1097/JOM.0b013e318240de33
Original Articles

Objective: Quantify temporal changes in opioid use.

Methods: Claim and prescription data for Louisiana Workers' Compensation Corporation claims open from 1999 and 2009 were analyzed by claim age and type of opioid.

Results: There was a significant cumulative yearly increase in morphine milligram equivalents prescribed for claimants with acute pain (55-mg increase per year), as well as chronic pain (461-mg increase per year). The cost per morphine milligram equivalent was approximately the same ($0.06 to $0.07) for long- and short-acting medications, but the medication cost was 8 times higher in claims where long-acting opioids were prescribed (with or without short-acting opioids) versus only short-acting medications.

Conclusions: The annual cumulative dose and cost of opioids per claim increased over the study period related to an increase in prescriptions for long-acting opioids.

From the Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Bernacki and Tao); Louisiana Workers' Compensation Corporation, Baton Rouge, Louisiana (Mr Yuspeh); and Rehabilitation Division, Department of Neurology, University of Maryland School of Medicine, Baltimore (Dr Lavin).

Address correspondence to: Edward J. Bernacki, MD, MPH, Johns Hopkins University, School of Medicine, 600 North Wolfe St, Billings Administration 129, Baltimore, MD 21287 (

Copyright © 2012 by the American College of Occupational and Environmental Medicine