BACKGROUND: Workers’ Compensation programs ensure that workers injured on the job receive appropriate medical care and wage replacement if necessary. Past studies in other states have shown that workers’ compensation claimants have had higher drug overdose death rates than the overall working age population. A leading risk factor for drug overdose death is a history of use of prescription opioids. Long term use and high doses (which are related) have been shown to be risk factors for overdose death.
METHODS: Injury claim data for initial claims in 2007-2015 from the New Mexico Worker’s Compensation Administration were linked by name and date of birth to overdose death data from the Office of the Medical Investigator and prescription records from the New Mexico PMP. De-duplication of injury claimants and linkage were done using The Link King ®, and data aggregation and analysis were done in SAS9.4. Claims and prescriptions were aggregated to the level of individuals.
RESULTS: There were 125,466 individuals with workers’ compensation claims in the time period for whom at least one payment was made. Among these individuals, there were 62 overdose deaths within one year of the last action recorded by the workers’ compensation administration. For claimants with a date of last action in 2007-2014, the overdose death rate averaged 49.6/100,000. Statewide, the overdose death rate averaged 34.2/100,000 over the same period. Claimants with heavy prescription opioid use (at least 90 days of opioid coverage, covering at least 25% of the time between the first and last opioid fills) accounted for 43% of overdose deaths and had an overdose death rate of 311/100,000. Those with no opioid prescriptions or light opioid use (longest prescription < 5 days of total days < 20) accounted for 33% of overdose deaths and had an overdose death rate of 25/100,000. The fraction of workers’ compensation claimants with heavy prescription opioid use has declined from 8.5% of injuries in 2007 to 3.3% of injuries in 2015.
CONCLUSIONS: As has been seen elsewhere, workers’ compensation claimants had a higher drug overdose death rate than the overall population in the same general age group in New Mexico over the period. Overdose death is much more likely among claimants with heavy prescription opioid use than those with no or light prescription opioid use. Heavy use of prescription opioids is falling over time among New Mexico workers’ compensation claimants.