Natural History of Opioid Dosage Escalation Post-Injury: A Cohort Study of Injured Workers in the State of Louisiana

Objective: To determine the relationship between opioid dosage and claim duration. Methods: Closure rates and morphine-equivalent dose were analyzed over a 7-year period for 11,394 lost-time claims filed with the Louisiana Workers' Compensation Corporation. Results: The percentage of claims in which opioids were ever prescribed increased from 43.3% in year 1 to 80.8% in year 7 post-injury. The percentage of claims in which individuals were prescribed long-acting (LA) opioids increased from 5.2% to 29.6%, and the percentage of claims in which individuals were prescribed only shortacting (SA) opioids increased from 38.1% to 51.2%. Morphine-equivalent dose increased from 10.0 mg/day (year 1) to 143.2 mg/day (year 7) for claims in which individuals were prescribed LA opioids. The average claim duration for claims in which individuals were prescribed no opioids, only SA opioids, and LA opioids was 415, 930, and 2025 days, respectively. Conclusion: Opioid dosage escalates as claims mature.