Injured rural workers more likely to be prescribed opioids

Chart by Workers Compensation Research Institute; for a larger, clearer version, click on it

A study has found that injured workers who live in rural areas are more likely to be prescribed opioids, especially older workers, employees of small companies, and workers in physically challenging occupations such as mining and construction.

The Workers' Compensation Research Institute, an independent nonprofit, analyzed data from 1.4 million post-injury pain medication prescriptions in 27 states from October 2014 to September 2015 (before the Centers for Disease Control and Prevention tightened opioid prescription guidelines, in 2016) to see how a worker's age, injury, occupation and location affected whether they were prescribed opioids, Liz Carey reports for The Daily Yonder.

"According to the study, two-thirds of injured patients in rural and very rural areas received at least one opioid prescription, where one third received two or more prescriptions," Carey reports. "But those in rural areas were only slightly more likely to stay on the prescriptions longer, with 10 percent of those injured workers on opioids having prescriptions for 60 days or more, as compared to 9 percent in rural areas."

The study didn't address causality, but Dr. Vennela Thumula, the study's author, told Carey that rural-urban differences in health care, education, income, unemployment, and other quality-of-life factors can play a role in opioid prescription rates.

The size of the injured person's employer also mattered. The study found that "injured employees who worked for small businesses, or those having a payroll of less than $20 million, were [also] more likely to be prescribed opioids," Carey reports. "The study found that 54 percent of injured employees of companies with payrolls between $1 million and $4 million were given at least one prescription for opioids, compared to 47 percent of those employed by companies with payrolls between $20 million to $80 million. Injured workers at those small companies were also more likely to have two or more opioid prescriptions, and to have long term prescriptions."

WCRI studied data from Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin, Carey reports.