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Impact of workplace injury on opioid dependence, abuse, illicit use and overdose: a 36-month retrospective study of insurance claims
  1. Abay Asfaw1,
  2. Leslie I Boden2
  1. 1 NIOSH, Centers for Disease Control and Prevention, Washignton, District of Columbia, USA
  2. 2 Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Abay Asfaw, NIOSH, Centers for Disease Control and Prevention, Washignton, DC 20201, USA; hqp0{at}


Objectives To examine the impact of workplace injury on opioid dependence, abuse and overdose (opioid-related morbidity) and if severity of injury increases the hazard of these health effects.

Methods We used MarketScan databases to follow injured and propensity score matched non-injured workers, both without prior opioid-related diagnoses. Using a Cox proportional hazard model, we examined the impact of workplace injury on opioid-related morbidity.

Results The hazard of opioid-related morbidity for injured workers was 1.79 times than that of matched non-injured workers (95% CI 1.89 to 3.60). For medical-only and lost-time injured workers, it was respectively 1.54 (95% CI 1.02 to 2.32) and 2.91 (95% CI 1.75 to 4.84) times that of non-injured workers.

Conclusions Reducing workplace injury or severity of workplace injury, as well as efforts to ensure appropriate opioid prescribing for injured workers, may help to reduce the societal costs of opioid use.

  • occupational health practice
  • public health
  • injury

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  • Contributors Both authors contributed equally to this work. AA designed the study and performed the data analysis. LIB drafted the discussion section and helped with refining the analysis and interpreting results. Both authors read and approved the final manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval MarketScan Research Databases are fully compliant with the Health Insurance Portability and Accountability Act, and no Institutional Review Board approval was necessary because individual patients were not identifiable with the data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. The data we used for the analyses, the IBM MarketScan Research Databases, are available only for subscribers (