title: Impact of the combined use of benzodiazepines and opioids on workers' compensation claim cost.
abstract: OBJECTIVE
  Study the use patterns and claim cost impact of prescription opioids and benzodiazepines in workers' compensation.
  
  
  METHODS
  A cohort of 11,394 lost time claims filed with the Louisiana Workers' Compensation Corporation from 1999 to 2002 was observed for 7 years post injuries.
  
  
  RESULTS
  We found that benzodiazepines are almost always prescribed in combination with opioids. The odds ratios of benzodiazepines used alone, with short-acting opioids and with long-acting opioids for claims ≥$100,000, were 2.74, 4.69, and 14.24, respectively (after controlling for gender, low back pain, marital status, attorney involvement, and each other). Average benzodiazepine daily dose increased to year 3 postinjury and plateaued thereafter, whereas the average opioid dose escalated each year postinjury.
  
  
  CONCLUSIONS
  The addition of benzodiazepines to an opioid treatment regimen significantly increases workers' compensation costs.
authors.affiliation: From the Department of Neurology (Dr Lavin), University of Maryland School of Medicine; Division of Occupational and Environmental Medicine (Drs Tao and Bernacki), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; and Strategic Risk and Strategy Management (Ms Yuspeh), Louisiana Workers' Compensation Corporation, Baton Rouge.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lavin
authors.forename: Xuguang Grant
authors.initials: XG
authors.lastname: Tao
authors.forename: Larry
authors.initials: L
authors.lastname: Yuspeh
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bernacki
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000191:economics* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D016001:Confidence Intervals; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008145:Louisiana; D008297:Male; D060051:Occupational Injuries / Q000188:drug therapy / Q000191:economics*; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D014942:Workers' Compensation / Q000191:economics*
chemical_list: D000701:Analgesics, Opioid; D001569:Benzodiazepines