Higher opioid doses lead to poorer outcomes for MSD sufferers

Chronic opioid use beginning after an individual suffers a work-related musculoskeletal disorder doesn't always lead to successful outcomes, according to a study.

Opioids are frequently used for the postoperative treatment of chronic disabling occupational MSDs. The researchers, from the University of Texas and the Productive Rehabilitation Institute of Dallas for Ergonomics, said that long-term opioid use persists in many such cases because employees' request relief for ongoing pain.

For the study, researchers examined more than 1,200 employees with a chronic disabling, work-related MSD. The individuals were admitted into an interdisciplinary functional restoration program and divided into two groups -- one group who reported no opioid use at the time of admission and another group who reported some opioid use at the time of admission. During the initial weeks of treatment, individuals consented to be weaned from all opioid medications. In addition, the patients were assessed before and after rehabilitation with regard to self-reported measures of pain, function and depression and were analyzed for change. One year after the termination of treatment, socioeconomic outcomes were assessed to measure work and financial status, health care utilization, and recurrent injury-associated pain.

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The researchers found that a higher postinjury opioid dose was associated with a greater risk of program noncompletion. High opioid use was significantly related to important socioeconomic outcomes, such as lower rates of return to work and work retention, as well as higher health care utilization. Moreover, at one year after treatment, the group reporting the highest opioid use was 11.6 times as likely to be receiving Social Security Disability Income/Supplemental Security Income as compared with the group reporting no opioid use at the start of the program.

June 18, 2009

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