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Costs and Work Loss Burden of Diagnosed Opioid Abuse Among Employees on Workers Compensation or Short-term Disability

Johnston, Stephen S. MA; Alexander, Andrea H. MBA; Masters, Elizabeth T. MS, MPH; Mardekian, Jack PhD; Semel, David PharmD; Malangone-Monaco, Elisabetta MS; Riehle, Ellen MPH; Wilson, Kathleen MS; Sadosky, Alesia PhD

Journal of Occupational and Environmental Medicine: November 2016 - Volume 58 - Issue 11 - p 1087–1097
doi: 10.1097/JOM.0000000000000865

Objective: To compare 12-month healthcare costs between employees with versus without diagnosed opioid abuse within 12 months after an injury-related workers’ compensation (WC) or short-term disability (STD) claim.

Methods: Retrospective study using 2003 to 2014 US insurance claims linked to administrative data on WC/STD claims. Multivariable models compared healthcare costs between employees with versus without diagnosed opioid abuse.

Results: Study included 107,975 opioid-treated employees with an injury-related WC or STD claim. Mean number of opioid prescription fills and adjusted total healthcare costs were substantially greater in employees with diagnosed opioid abuse versus without (WC: 13.4 vs. 4.5, P < 0.001; $18,073 vs. $8470, P < 0.001; STD: 13.7 vs. 4.5, P < 0.001; $25,693 vs. $14,939, P < 0.001).

Conclusion: Opioids are commonly prescribed to employees with injury-related WC/STD claims. Employers may benefit from proactively addressing the issue of opioid abuse in these populations.

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Truven Health Analytics, Bethesda, Maryland (Mr Johnston, Ms Malangone-Monaco, Ms Riehle, Ms Wilson); and Pfizer Inc., New York, New York (Ms Alexander, Ms Masters, Drs Mardekian, Semel, Sadosky).

Address correspondence to: Elisabetta Malangone-Monaco, MS, Truven Health Analytics; 7700 Old Georgetown Rd. Ste 650 Bethesda, MD 20814 (

This study was funded by Pfizer Inc. Andrea H. Alexander, Elizabeth T. Masters, Jack Mardekian, David Semel, and Alesia Sadosky are employees of Pfizer Inc. Stephen S. Johnston, Elisabetta Malangone-Monaco, Ellen Riehle, and Kathleen Wilson are employees of Truven Health Analytics, who were paid consultants to Pfizer to conduct this study and in the development of this manuscript.

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2016 by the American College of Occupational and Environmental Medicine