A Study of the Effectiveness of Opioid Treatment between Workers' Compensated Patients and Non-workers' Compensated Patients with Chronic Musculoskeletal Pain

Open Access
Author:
Kammerman, Jacob S
Area of Honors:
Biobehavioral Health
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
  • Frank Martin Ahern, Thesis Supervisor
  • Lori Anne Francis, Faculty Reader
  • Henriette Evans, Honors Advisor
Keywords:
  • opioid
  • treatment
  • workman's compensation
  • VAS
  • musculoskeletal
Abstract:
Throughout the past twenty years there has been a large emphasis on increased treatment for chronic, non-terminal illnesses. In the mid 1990s pain management physicians throughout the United States began increasing their rate of opioid prescriptions in an effort to meet this new pressure. In recent years, however, these doctors have been the subject of criticism for what many believe is a severe over prescription of opioids. These critics argue that long-term opioid treatment for chronic pain is ineffective and ultimately does more harm than good. This study was performed with the assistance of a pain management clinic in upstate New York, and aimed to investigate the effectiveness of opioids as a long-term treatment for patients with chronic musculoskeletal pain. Subjects were comprised of 100 workers’ compensated patients and 100 non-workers’ compensated patients receiving opioid treatment. Opioid effectiveness was determined through the analysis of self-reported visual analog scale (VAS) scores of the subjects over six consecutive office visits. In addition to this, demographical information including age, gender, marital status, race, and drug screen statuses were analyzed. It was expected that overall the workers’ compensated patients would show a smaller decrease than the non-workers’ compensated patients in VAS scores over the six visits based on the fact that workers’ compensated patients have a financial incentive to report higher levels of pain. It was also anticipated that the opioid treatments would not greatly improve the VAS scores of either group. Although the experiment suggested a significant difference in change of VAS scores over the six visits between the two groups, there were inconsistencies when the reported scores were examined visit by visit. It was determined, though, that there was a significant association between gender, age, and drug screen status with workers’ compensation status. Despite the fact that workers’ compensated patients showed a lesser decrease in VAS scores, overall neither group’s decrease in VAS score was substantial.