Opioid poisonings and opioid adverse effects in workers in Washington State

Authors

  • Deborah Fulton-Kehoe PhD,

    Corresponding author
    1. Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington
    • Correspondence to: Deborah Fulton-Kehoe, PhD, 130 Nickerson St., Suite 212 Seattle, WA 98109. E-mail: debfk@u.washington.edu

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  • Renu K. Garg MPH,

    1. Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington
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  • Judith A. Turner PhD,

    1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
    2. Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington
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  • Amy M. Bauer MD, MS,

    1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
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  • Mark D. Sullivan MD, PhD,

    1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
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  • Thomas M. Wickizer PhD,

    1. Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, Ohio
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  • Gary M. Franklin MD, MPH

    1. Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington
    2. Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, Washington
    3. Washington State Department of Labor and Industries, Olympia, Washington
    4. Department of Neurology, University of Washington School of Medicine, Seattle, Washington
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  • Disclosure Statement: The authors report no conflicts of interests.

Abstract

Objective

To examine trends in opioid poisonings and adverse effects in Washington (WA) State and nationally.

Methods

We calculated rates of opioid poisonings and adverse effects and examined opioid prescriptions in the WA workers' compensation system, 2004–2010. Using Health Care Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) data, we also calculated national rates of opioid poisonings and adverse effects, 1993–2010.

Results

We identified 96 opioid poisonings and 312 opioid-related adverse effects in WA, 2004–2010. The rates did not change substantially over these years. Most poisonings and adverse effects occurred in cases without chronic opioid use and with prescribed doses <120 mg/day morphine-equivalent dose. Nationally, the rates of opioid poisonings and adverse effects increased significantly from 1993 to 2010.

Conclusions

Many poisonings and adverse effects occurred in patients without high dose or long-term opioid therapy, suggesting that opioid dosing and duration guidelines may not be sufficient to reduce morbidity related to prescription opioid use. Am. J. Ind. Med. 56:1452–1462, 2013. © 2013 Wiley Periodicals, Inc.

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