title: Opioid poisonings and opioid adverse effects in workers in Washington state.
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.
authors.affiliation: Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington.
authors.forename: Deborah
authors.initials: D
authors.lastname: Fulton-Kehoe
authors.forename: Renu K
authors.initials: RK
authors.lastname: Garg
authors.forename: Judith A
authors.initials: JA
authors.lastname: Turner
authors.forename: Amy M
authors.initials: AM
authors.lastname: Bauer
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sullivan
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Wickizer
authors.forename: Gary M
authors.initials: GM
authors.lastname: Franklin
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000506:poisoning*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D011041:Poisoning / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology; D014942:Workers' Compensation
chemical_list: D000701:Analgesics, Opioid
keywords: Nationwide Inpatient Sample; opioid; opioid adverse effect; opioid morbidity; opioid poisoning; workers' compensation