Is Early Prescribing of Opioid and Psychotropic Medications Associated With Delayed Return to Work and Increased Final Workers’ Compensation Cost?

OBJECTIVE:To explore the association between the initial 60 days of prescriptions for psychotropic medications and final workers’ compensation claim outcomes. METHODS:A cohort of 11,394 claimants involved in lost time injuries between 1999 and 2002 were followed through December 31, 2009. Logistic regressions and Cox Proportional Hazard Models were used in the analysis. RESULTS:The initial 60 days of prescriptions for psychotropic medications were significantly associated with a final claim cost at least $100,000. Odds ratios were 1.88 for short-acting opioids, 2.14 for hypnotics, antianxiety agents, or antidepressants, and 3.91 for long-acting opioids, respectively. Significant associations were also found between decreased time lost from work and decreased claim closures during the study period. CONCLUSIONS:Early prescription of opioids and other psychotropic drugs may be useful predictors of high claim costs and time lost from work.