title: Natural history of opioid dosage escalation post-injury: a cohort study of injured workers in the State of Louisiana.
abstract: OBJECTIVE
  To determine the relationship between opioid dosage and claim duration.
  
  
  METHODS
  Closure rates and morphine-equivalent dose were analyzed over a 7-year period for 11,394 lost-time claims filed with the Louisiana Workers' Compensation Corporation.
  
  
  RESULTS
  The percentage of claims in which opioids were ever prescribed increased from 43.3% in year 1 to 80.8% in year 7 post-injury. The percentage of claims in which individuals were prescribed long-acting (LA) opioids increased from 5.2% to 29.6%, and the percentage of claims in which individuals were prescribed only short-acting (SA) opioids increased from 38.1% to 51.2%. Morphine-equivalent dose increased from 10.0 mg/day (year 1) to 143.2 mg/day (year 7) for claims in which individuals were prescribed LA opioids. The average claim duration for claims in which individuals were prescribed no opioids, only SA opioids, and LA opioids was 415, 930, and 2025 days, respectively.
  
  
  CONCLUSIONS
  Opioid dosage escalates as claims mature.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Xuguang Grant
authors.initials: XG
authors.lastname: Tao
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lavin
authors.forename: Larry
authors.initials: L
authors.lastname: Yuspeh
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bernacki
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D015331:Cohort Studies; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D060051:Occupational Injuries / Q000150:complications* / Q000453:epidemiology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D014942:Workers' Compensation
chemical_list: D000701:Analgesics, Opioid