Impact of the Combined Use of Benzodiazepines and Opioids on Workers' Compensation Claim Cost

OBJECTIVE: Study the use patterns and claim cost impact of prescription opioids and benzodiazepines in workers' compensation. METHODS: A cohort of 11,394 lost time claims filed with the Louisiana Workers' Compensation Corporation from 1999 to 2002 was observed for 7 years post injuries. RESULTS: We found that benzodiazepines are almost always prescribed in combination with opioids. The odds ratios of benzodiazepines used alone, with short-acting opioids and with long-acting opioids for claims ≥$100,000, were 2.74, 4.69, and 14.24, respectively (after controlling for gender, low back pain, marital status, attorney involvement, and each other). Average benzodiazepine daily dose increased to year 3 postinjury and plateaued thereafter, whereas the average opioid dose escalated each year postinjury. CONCLUSIONS: The addition of benzodiazepines to an opioid treatment regimen significantly increases workers' compensation costs.