Impact of the combined use of benzodiazepines and opioids on workers' compensation claim cost

J Occup Environ Med. 2014 Sep;56(9):973-8. doi: 10.1097/JOM.0000000000000203.


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.

MeSH terms

  • Adult
  • Analgesics, Opioid / economics*
  • Analgesics, Opioid / therapeutic use
  • Benzodiazepines / economics*
  • Benzodiazepines / therapeutic use
  • Cohort Studies
  • Confidence Intervals
  • Drug Costs
  • Drug Therapy, Combination
  • Female
  • Humans
  • Louisiana
  • Male
  • Occupational Injuries / drug therapy
  • Occupational Injuries / economics*
  • Odds Ratio
  • Practice Patterns, Physicians'
  • Workers' Compensation / economics*


  • Analgesics, Opioid
  • Benzodiazepines