Dose Escalations Among Workers’ Compensation Claimants Using Opioid Medications—An 8 Year Postinjury Follow up Study

Abstract

Objective The aim of the study is to determine the morphine equivalent dose in milligrams (MED)/day escalation trend after initial utilization. Methods A total of 25,108 lost time claims filed between 1998 and 2007 were followed for 8 years from injury date. Claims were stratified by initial MED/day at 3 months after injury into four groups (0, 1 to < 15, 15 to < 30, and ≥30 MED/day). The slopes in MED/year of opioid dose escalation were determined for each initial MED/day group. Results The slopes of MED/day escalation by initial MED categories were similar (P ≥ 0.05) ranging from 5.38 to 7.76 MED annually. On average, MED/day increased in a liner pattern with a slope at 6.28 MED/year (P < 0.01). Conclusions Opioid MED/day increased in a linear pattern, regardless of initial MED/day dose.