Injured workers receiving ‘high-risk opioid prescriptions'

An alarming study has shown that one in five injured Victorian workers are receiving high-risk opioid prescriptions – opening up employees to harmful, addictive opioid usage.

A study conducted by Monash University that analysed data from over 30,000 Victorian employees who suffered back and neck injuries between 2010 and 2019 found that of these workers – 6,278 ( close to 20.5 per cent) were prescribed opioids in the first three months of their workers’ compensation claim.

The finding was rather alarming based on the fact that opioids are classed as a high-risk drug, with Monash claiming that it is generally recommended to avoid opioids if possible and use other pain relief methods first.

According to the data, of those prescribed opioids in the first three months of their workers’ compensation, two out of three workers (67.1 per cent) had early high-risk opioid prescriptions, and nearly one in four (22.8 per cent) continued using opioids after a year.

“We analysed detailed data on the type, volume and timing of opioid prescriptions paid for by the workers’ compensation system,” said author Yonas Tefera of Monash University’s School of Public Health and Preventive Medicine Healthy Working Lives Research Group.

“Prescribing was considered high-risk if there was a large volume prescribed within the first three months, if long-acting opioids were prescribed early, or if other high-risk medicines were prescribed at the same time as opioids.”

“We also found that early high-risk prescribing doubled the chances of long-term opioid use. Previous studies show that injured workers who use opioids early or for a long time tend to have more time off work and worse health outcomes.”

The longer duration of time off work and negative health outcomes derived from long-term opioid usage were eye-opening findings. Another was the fact that workers in rural and more economically challenged locations were more likely to receive early high-risk opioid prescriptions – and also long-term usage.

Senior author and Healthy Working Lives Research Group director Professor Alex Collie touched on the two harmful flow-on effects among workers who have workplace injuries and compensation claims.

“More than 120,000 Australians have workers’ compensation claims involving more than a week off work every year, and many of these claims are for back and neck injuries,” said Collie.

“If the patterns we observe in Victoria also occur in other states and territories, then potentially thousands of workers are receiving high-risk opioid prescriptions funded by our workers’ compensation systems.”

“This study highlights the need for stronger monitoring of prescription patterns in our workers’ compensation systems and the need for stronger approaches to prevent potentially harmful prescription opioid use.”

Collie raised that Victoria is only one of two states that allow for this collection of data, pointing out that other states don’t have the parameters to collect detailed information on what medicines are being prescribed through compensation systems.

“Victoria is one of only two states in the country where this sort of analysis is possible, because the other state workers’ compensation systems aren’t collecting detailed information on the medicines they are paying for,” said Collie.

It raises yet another issue surrounding the differences and separation of workers’ compensation systems that operate throughout Australia. On a recent HR Leader podcast, Aon workplace risk director Gary McMullen proclaimed the need for a national workers’ compensation scheme, claiming the current system that involves 11 separate schemes is no longer efficient.

“The current workers’ compensation scheme, in my words, is fractured, and it doesn’t need to be, which is why I’ve been talking about a national workers’ compensation scheme of late,” said McMullen.

“They’re typically regulated by separate government bodies, and employers are required to have separate workers’ compensations per jurisdiction. It’s a bit of a fractured mess.”