Enass Awad A Rahman

Project title: The Natural History of Opiate use Among Workers with Low Back Injuries in the Washington State Workers' Compensation System

Degree: MPH | Program: Occupational and Environmental Medicine (OEM) | Project type: Thesis/Dissertation
Completed in: 2008 | Faculty advisor: David L. Eaton


Opioids continue to be prescribed in increasing amounts for the management of chronic non-cancer pain in general and for musculoskeletal pain in particular. Despite little change in musculoskeletal pain office visit rates, US office-based opioid prescriptions increased for acute musculoskeletal pain and doubled for chronic musculoskeletal pain in the period between 1980 and 2000.

With the realization of the potential risks associated with opiate use in chronic non-cancer pain and the uncertainty about their actual contribution to pain relief and improvement in functionality, research about actual dose trends over longer terms and the accompanying changes in pain and function may provide basic knowledge that can be of great value in helping providers formulate better treatment plans with realistic goals to be achieved by prescribing these medications.

This study aims to describe the natural history of opiate use among workers with compensable low back injuries in the Washington State Workers' Compensation System. it specifically aims to describe the changes in the Morphine Equivalent Dose (MED) for all opiates used by following the observed trends that occur across four consecutive quarters following an initial medical visit for a low back injury. The use of MED is meant to provide a standardized measure that encompasses all opioids that are received by the workers. Duration of use of opiates (number of quarters), the number of opiate prescriptions that they receive and their total MED/quarter and MED/day will be described.

Taken from the beginning of thesis.