Opioid poisonings and opioid adverse effects in workers in Washington state

Am J Ind Med. 2013 Dec;56(12):1452-62. doi: 10.1002/ajim.22266. Epub 2013 Oct 10.


Objective: To examine trends in opioid poisonings and adverse effects in Washington (WA) State and nationally.

Methods: We calculated rates of opioid poisonings and adverse effects and examined opioid prescriptions in the WA workers' compensation system, 2004-2010. Using Health Care Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) data, we also calculated national rates of opioid poisonings and adverse effects, 1993-2010.

Results: We identified 96 opioid poisonings and 312 opioid-related adverse effects in WA, 2004-2010. The rates did not change substantially over these years. Most poisonings and adverse effects occurred in cases without chronic opioid use and with prescribed doses <120 mg/day morphine-equivalent dose. Nationally, the rates of opioid poisonings and adverse effects increased significantly from 1993 to 2010.

Conclusions: Many poisonings and adverse effects occurred in patients without high dose or long-term opioid therapy, suggesting that opioid dosing and duration guidelines may not be sufficient to reduce morbidity related to prescription opioid use.

Keywords: Nationwide Inpatient Sample; opioid; opioid adverse effect; opioid morbidity; opioid poisoning; workers' compensation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / poisoning*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Injuries / complications
  • Occupational Injuries / drug therapy*
  • Pain / drug therapy*
  • Pain / etiology
  • Poisoning / epidemiology
  • United States / epidemiology
  • Washington / epidemiology
  • Workers' Compensation


  • Analgesics, Opioid