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Shorter Time Between Opioid Prescriptions Associated With Reduced Work Disability Among Acute Low Back Pain Opioid Users

Cifuentes, Manuel MD, ScD; Powell, Ryan MA; Webster, Barbara BSPT, PA-C

Journal of Occupational and Environmental Medicine: April 2012 - Volume 54 - Issue 4 - p 491–496
doi: 10.1097/JOM.0b013e3182479fae
Original Articles

Objective: To explore whether average time between opioid prescriptions is associated with shorter time off work.

Methods: Claims from 1422 work-related acute low back pain cases with at least two opioid prescriptions during the first month and at least 1 day of disability after the first month. Intended duration of first month opioid prescriptions was computed and averaged.

Results: After controlling for demographic and severity indicators, each additional week between opioid prescriptions predicted 14% longer disability (risk ratio, 1.14; 95% confidence interval, 1.06 to 1.22). This association remained robust in sensitivity analyses.

Conclusions: Fewer days between opioid prescriptions were associated with shorter time off work. The mechanism of this effect is unknown but may be related to provider's close monitoring of the patient's pain and function, as well as addressing barriers that may prevent workers from returning to work.

From the Center for Disability Research at Liberty Mutual Research Institute for Safety (Dr Cifuentes, Mr Powell, and Ms Webster), Boston, Mass; and Work Environment Department at University of Massachusetts Lowell (Dr Cifuentes).

Address correspondence to: Manuel Cifuentes, MD, ScD, 71 Frankland Rd, Hopkinton, MA 01748 (;

Disclosure: The authors declare no conflict of interest.

©2012The American College of Occupational and Environmental Medicine