title: Is Early Prescribing of Opioid and Psychotropic Medications Associated With Delayed Return to Work and Increased Final Workers' Compensation Cost?
abstract: OBJECTIVE
  To explore the association between the initial 60 days of prescriptions for psychotropic medications and final workers' compensation claim outcomes.
  
  
  METHODS
  A cohort of 11,394 claimants involved in lost time injuries between 1999 and 2002 were followed through December 31, 2009. Logistic regressions and Cox Proportional Hazard Models were used in the analysis.
  
  
  RESULTS
  The initial 60 days of prescriptions for psychotropic medications were significantly associated with a final claim cost at least $100,000. Odds ratios were 1.88 for short-acting opioids, 2.14 for hypnotics, antianxiety agents, or antidepressants, and 3.91 for long-acting opioids, respectively. Significant associations were also found between decreased time lost from work and decreased claim closures during the study period.
  
  
  CONCLUSIONS
  Early prescription of opioids and other psychotropic drugs may be useful predictors of high claim costs and time lost from work.
authors.affiliation: Division of Occupational and Environmental Medicine (Dr Tao), Department of Medicine, Johns Hopkins University School of Medicine; Department of Neurology (Dr Lavin), University of Maryland School of Medicine, Baltimore; Strategic Risk and Strategy Management (Ms Yuspeh), Louisiana Workers' Compensation Corporation, Baton Rouge; Department of Environmental Health Sciences and Medicine (Dr Weaver), Johns Hopkins University Medical Institutions; and Division of Occupational and Environmental Medicine (Dr Bernacki), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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: Virginia M
authors.initials: VM
authors.lastname: Weaver
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bernacki
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000191:economics / Q000627:therapeutic use*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D008145:Louisiana; D008297:Male; D060051:Occupational Injuries / Q000188:drug therapy* / Q000191:economics; D016016:Proportional Hazards Models; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use*; D062707:Return to Work / Q000191:economics / Q000706:statistics & numerical data*; D013997:Time Factors; D014942:Workers' Compensation / Q000191:economics* / Q000706:statistics & numerical data
chemical_list: D000701:Analgesics, Opioid; D011619:Psychotropic Drugs