Prevalence and Risk Factors Associated With Long-term Opioid Use After Injury Among Previously Opioid-Free Workers

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Abstract
Long-term opioid use is about more than the number of days someone takes an opioid; it is also about the threshold at which the costs of opioid use begin to outweigh the advantages. Research on long-term opioid use for chronic pain was summarized in a systematic review of clinical trials and observational studies,1 which reported no evidence of effectiveness for opioid use of greater than 3 months but increased risk of harms, including overdose, substance use disorder, fractures, and myocardial infarction. An epidemiological study2 showed that long-term opioid use is associated with dependence, addiction, poor self-rated health, inactivity, unemployment, higher health care utilization, and poor self-rated quality of life. In injured workers specifically, long-term opioid therapy is associated with higher health care costs3 and lower productivity.4

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