Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey

Alghnam, Suliman; Castillo, Renan C.

doi:10.1136/injuryprev-2016-042059

Cited by 44 publications

(31 citation statements)

References 32 publications

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“…The racial-ethnic disparities in prescription opioid use among construction workers reported in this study confirm previous research indicating that minorities are less likely to receive prescription opioids. 13,21,26,55 In addition to variations in age, insurance coverage, and other variables examined in this study, the effect of race/ethnicity in a physician's decision to prescribe opioids [65][66][67] may have contributed to lower prescribed opioid use among Hispanic construction workers.…”

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confidence: 94%

“…54 In fact, workers with poorer physical or mental health were more likely to use prescription opioids as shown in this study and previous research. 26,36,55 The higher odds of prescription opioid use among older construction workers (≥55 years) could be attributed to the higher prevalence of musculoskeletal disorders and chronic conditions among workers in this age group. 33,56,57 In addition to aging, job exposures in construction could worsen health conditions among workers whose long-term job was in construction.…”

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confidence: 99%

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Prescription opioid use and associated factors among US construction workers

Dong

Brooks

Cain

2020

American J Industrial Med

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Background Construction workers are among the segments of the US population that were hit hardest by the opioid prescription and overdose deaths in the past decades. Factors that underlie opioid use in construction workers have been compartmentalized and isolated in existing studies of opioid use and opioid overdose, but they ignore the overall context of their use. This study examines prescription opioid use and its association with a variety of occupational and nonoccupational factors in construction workers in the United States. Methods Data from the 2011‐2017 Medical Expenditure Panel Survey (n = 7994) were analyzed. The prevalence of prescribed opioid use and the association with occupational and nonoccupational characteristics among construction workers were examined in four multiple logistic regression models. Results The odds of prescription opioid use for workers with occupational injuries was more than triple that of their noninjured counterparts when demographics and occupational factors were controlled (odds ratio = 3.38, 95% confidence interval: 2.38‐4.81). Odds of prescription opioid use were higher in older construction workers, workers who were white, non‐Hispanic, working part‐time, and in poorer health, while Hispanic workers and those without health insurance were much less likely to report prescription opioid use. Conclusions Prescription opioid use among construction workers encompasses both occupational and nonoccupational factors. As an insight into opioid use among construction workers becomes clearer, effectively responding to the opioid crisis remains a challenge.

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confidence: 94%

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confidence: 99%

Prescription opioid use and associated factors among US construction workers

Dong

Brooks

Cain

2020

American J Industrial Med

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“…This table only includes predictor variables that were in more than one model. Studies with opioid-naïve sample37,[39][40][41]64,66,71 Results from Koeppe 2011 are not included because the definition of opioid-naïve sample differed from the other studies. 73 a…”

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confidence: 99%

Long‐term opioid therapy definitions and predictors: A systematic review

Karmali

Bush

Raman

et al. 2019

Pharmacoepidemiology and Drug

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Purpose This review sought to (a) describe definitions of long‐term opioid therapy (LTOT) outcome measures, and (b) identify the predictors associated with the transition from short‐term opioid use to LTOT for opioid‐naïve individuals. Methods We conducted a systematic review of the peer‐reviewed literature (January 2007 to July 2018). We included studies examining opioid use for more than 30 days. We classified operationalization of LTOT based on criteria used in the definitions. We extracted LTOT predictors from multivariate models in studies of opioid‐naïve individuals. Results The search retrieved 5,221 studies, and 34 studies were included. We extracted 41 unique variations of LTOT definitions. About 36% of definitions required a cumulative duration of opioid use of 3 months. Only 17% of definitions considered consecutive observation periods, 27% used days' supply, and no definitions considered dose. We extracted 76 unique predictors of LTOT from seven studies of opioid‐naïve patients. Common predictors included pre‐existing comorbidities (21.1%), non‐opioid prescription medication use (13.2%), substance use disorders (10.5%), and mental health disorders (10.5%). Conclusions Most LTOT definitions aligned with the chronic pain definition (pain more than 3 months), and used cumulative duration of opioid use as a criterion, although most did not account for consistent use. Definitions were varied and rarely accounted for prescription characteristics, such as days' supply. Predictors of LTOT were similar to known risk factors of opioid abuse, misuse, and overdose. As LTOT becomes a central component of quality improvement efforts, researchers should incorporate criteria to identify consistent opioid use to build the evidence for safe and appropriate use of prescription opioids.

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“…Before initiation of prescription opioids, clinicians should discuss all known benefits and risks including potential risk of motor vehicle crashes with their patients. This is important because approximately 1 in 6 patients on prescription opioids becomes opioid-dependent (Alghnam and Castillo 2017) and because driving while on prescription opioids is a significant risk factor for fatal motor vehicle crashes.…”

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confidence: 99%

Prescription opioids, alcohol and fatal motor vehicle crashes: a population-based case-control study

Chihuri

2019

Inj. Epidemiol.

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Background: The prevalence of prescription opioid use among drivers has increased markedly in the past two decades. The purpose of this study is to assess the associations of prescription opioid use and alcohol use with the risk of fatal crash involvement in US drivers. Methods: We performed a population-based case-control study using toxicological testing data from two national data systems. Cases (n = 3606) were drivers involved in fatal motor vehicle crashes selected from the Fatality Analysis Reporting System and controls (n = 15,600) were drivers participating in the 2007 and 2013 National Roadside Surveys of Alcohol and Drug Use by Drivers. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) of fatal crash involvement associated with prescription opioid use with and without the presence of alcohol. Results: Overall, cases were significantly more likely than controls to test positive for prescription opioids (5.0% vs. 3.7%, p < 0.001), alcohol (56.2% vs. 7.1%, p < 0.0001), and both substances (2.2% vs. 0.2%, p < 0.001). Relative to drivers testing negative for prescription opioids and alcohol, the adjusted ORs of fatal crash involvement were 1.72 (95% CI: 1.37, 2.17) for those testing positive for prescription opioids and negative for alcohol, 17.92 (95% CI: 16.19, 19.84) for those testing positive for alcohol and negative for prescription opioids, and 21.89 (95% CI: 14.38, 33.32) for those testing positive for both substances. The interaction effect on fatal crash risk of prescription opioid use and alcohol use was not statistically significant on either additive or multiplicative scale. Conclusions: Prescription opioid use is associated with a significantly increased risk of fatal crash involvement independently of alcohol use. Concurrent use of prescription opioids and alcohol is associated with a 21-fold increased risk of fatal crash involvement.

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Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey

Cited by 44 publications

References 32 publications

Prescription opioid use and associated factors among US construction workers

Prescription opioid use and associated factors among US construction workers

Long‐term opioid therapy definitions and predictors: A systematic review

Prescription opioids, alcohol and fatal motor vehicle crashes: a population-based case-control study

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