Prevalence, Patterns, and Outcomes of Opioid Use by Injured Workers in Tennessee.
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2018-05
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Abstract
In this dissertation, three separate but related studies describe opioid use by injured workers in TN, identify patterns of opioid use by injured workers that are associated with nonfatal overdose, and develop a predictive model for the development of long-term opioid use in injured workers who were opioid-free at the time of injury. These studies link statewide databases to connect Workers’ Compensation records of injured workers to their prescription history in TN’s prescription drug monitoring program, hospital and emergency room records in TN’s Hospital Discharge Data System, and death certificates in TN’s Vital Statistics death certificates dataset. In a cross-sectional study, the prevalence of opioid use in injured workers is calculated and Poisson regression is used to assess prevalence ratios of the association between demographic and injury variables with opioid use. In a case-control study, the incidence of nonfatal overdose is calculated and conditional logistic regression is used to examine demographic, injury, and opioid use patterns that are associated with overdose. In a cohort study, unconditional logistic regression is used to build a predictive model of demographic, injury, and opioid use patterns that are associated with the development of long-term opioid use in previously opioid-free injured workers. These studies found that opioid use is widespread in injured workers after injury, but occurs largely within limits set by prescribing guidelines and tends to be discontinued within a month or two. Overdose and the development of long-term opioid use are rare, but affect vulnerable subsets of the population which may benefit from a different prevention and treatment approach than the overall population.
These studies were supported by funding from the Centers for Disease Control and Prevention’s Prescription Drug Overdose: Prevention for States program, grant number 5 NU17CE002731-02-00
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injured worker, opioid, benzodiazepine, long-term use, overdose
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