Abstract
Background
Patients with injury may be at high risk of long-term opioid use due to the specific
features of injury (e.g., injury severity), as well as patient, treatment, and provider
characteristics that may influence their injury-related pain management.
Objectives
Inform prescribing practices and identify high-risk populations through studying chronic
prescription opioid use in the trauma population.
Methods
Using the Washington State All-Payer Claims Database (WA-APCD) data, we included adults
aged 18–65 years with an incident injury from October 1, 2015–December 31, 2017. We
compared patient, injury, treatment, and provider characteristics by whether or not
the patients had long-term (≥ 90 days continuous prescription opioid use), or no opioid
use after injury.
Results
We identified 191,130 patients who met eligibility criteria and were included in our
cohort; 5822 met criteria for long-term use. Most had minor injuries, with a median
Injury Severity Score = 1, with no difference between groups. Almost all patients
with long-term opioid use had filled an opioid prescription in the year prior to their
injury (95.3%), vs. 31.3% in the no-use group (p < 0.001). Comorbidities associated with chronic pain, mental health, and substance
use conditions were more common in the long-term than the no-use group.
Conclusion
Across this large cohort of multiple, mostly minor, injury types, long-term opioid
use was relatively uncommon, but almost all patients with chronic use post injury
had preinjury opioid use. Long-term opioid use after injury may be more closely tied
to preinjury chronic pain and pain management than acute care pain management.
Keywords
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Article info
Publication history
Published online: May 02, 2022
Accepted:
April 23,
2022
Received in revised form:
April 1,
2022
Received:
January 20,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
