Workers who suffer on-the-job injuries and are eligible for workers’ compensation have greatly increased odds of dying of a drug overdose and from suicide, newly published research says.
The risk of suicide or overdose from opioid painkillers nearly triples in women with workplace injuries serious enough to keep them off the job for more than a week. Among men, the rate doubles according to the study published in the American Journal of Industrial Medicine.
Previous research has indicated that injured workers are frequently treated with opioid painkillers and are at increased risk of depression and loss of income. Based on this prior study, Boston University (BU) researchers questioned whether workplace injuries led to higher rates of opioid addiction and suicide.
Leslie Boden, BU professor of environmental health and a senior author of the study, said in a BU School of Public Health release the researchers found that men with a lost-time injury were 72% more likely to die from suicide and 29% more likely to die from drug-related causes. Women with lost-time injuries were 92% more likely to die from suicide and 193% more likely to die from drug-related causes.
The researchers did not explain why women suffered worse outcomes considering that overall more American men die from opioid overdoses than women, a MarketWatch report about the study says.
MarketWatch suggested that the limitations of the study include that it only looked at the experiences of workers in one state – 100,806 New Mexico workers injured on-the-job from 1994 through 2000.
Still, the BU researchers reported that drug overdoses and suicides have been rising since 2000 and are major contributors to a decline in U.S. life expectancy which the American Association of Family Physicians substantiates.
“Improved pain treatment, better treatment of substance use disorders, and treatment of post-injury depression may substantially improve quality of life and reduce mortality from workplace injuries,” Boden said.
Suicide, Overdoses and Workplace injuries
MarketWatch said the new study may even be underestimating the effects of more recent workplace injuries on suicide and opioid overdoses. Additional research is needed with larger populations of workers in other states over a longer period of time.
The CDC recently warned that 25 states saw suicide rates increase more than 30% in the past two decades. Prescription opioids contributed to more than 100,000 deaths in the U.S. between 2006 and 2012, according to the CDC.
In North Carolina, there were 1,953 overdose deaths involving opioids in 2017. North Carolina’s rate of 19.8 overdose deaths per 100,000 persons is higher than the national average of 14.6 deaths per 100,000 persons according to the National Institute on Drug Abuse (NIDA). This includes opioid prescriptions (such as OxyContin), synthetic opioids other than methadone (mainly fentanyl), and heroin. “The rate of overdose deaths involving just opioid prescriptions was 6.5 deaths per 100,000 persons in 2017 and has not significantly changed in the past several years,” the NIDA says.
The American Foundation for Suicide Prevention says there were 1,521 suicides in North Carolina in 2017, a rate of 14.26 per 100,000. There were 47,173 across the country, a rate of 14 per 100,000.
The North Carolina Violent Death Reporting System (NCVDRS) says there were 2,173 violent deaths in North Carolina in 2016, of which 1,362, or 62.7%, were suicides.
Males in North Carolina consistently had a higher suicide rate than females regardless of age. The suicide rate peaked for men 85 years and older at a rate of 44.2 per 100,000. Among women, the suicide rate peaked for ages 45-54 at 11.3 per 100,000 and steadily declined thereafter.
Further, a third of male suicide victims and nearly a third of female victims for whom there was information were characterized as being depressed when they committed suicide, NCVDRS says.
Elsewhere, multiple studies have identified an elevated risk of suicide among individuals who have suffered serious, long-term injury such as traumatic brain injury, spinal cord injury and serious burns.
The North Carolina Industrial Commission, which administers the state’s workers’ compensation program, has adopted rules for using opioids in treatment and pain management that are part of workers’ comp claims. The rules address:
- Initial prescriptions and the number and types of opioids prescribed
- Limits on morphine-equivalent dose per day
- Number of days’ supply per opioid prescription
- Assessing the employee’s risk of opioid-related harm using a screening tool
- Administering urine drug testing
- Use of benzodiazepines, carisoprodol (muscle relaxants) and opioid antagonists
- Nonpharmacological pain treatment
- Dependence or addiction treatment referrals
Dr. Douglas Lurie, orthopedic surgeon with Orthopaedic Associates of New Orleans, said in Risk & Insurance’s report about the BU study that the increased suicide and overdose risk among women could be attributable to the kinds of diagnoses that women receive over the course of treatment plus the fact that being out of work has a negative impact on your health.
Risk & Insurance cites a 2015 study published in the European Journal of Public Health from Oxford University that found the risk of death for any cause among the unemployed is nearly twice that of employed persons.
Get Help with Thoughts or Threats of Suicide or Substance Abuse
The attorneys at Younce, Vtipil, Baznik & Banks assist injured workers in North Carolina. We recognize that many injured workers that we meet are struggling physically, emotionally and financially after a serious work-related injury. We are committed to helping injured workers get the help and assistance they need.
The N.C. Department of Health and Human Services (DHHS) says suicides can be prevented by recognizing the signs and symptoms, learning how to help, and taking steps to provide that help to people in need.
Risk factors for suicide include:
- Previous suicide attempt(s)
- History of depression or other mental illness
- Alcohol or drug abuse
- Family history of suicide or violence
- Physical illness
- Feeling alone.
To learn more, visit the Centers for Disease Control and Prevention’s risk and protective factors and suicide prevention pages.
The National Suicide Prevention Lifeline is at 1-800-273-TALK or 1-800-273-8255.
Read about North Carolina’s response to the opioid epidemic, including how to get treatment and recovery support services for a substance abuse problem.
Find a variety of resources, including sources of help in each North Carolina county for a crisis involving substance abuse or mental health at the state’s Crisis Solutions North Carolina website.
About the Author
Robert C. Younce, JR
Chip is an attorney at Younce, Vtipil, Baznik & Banks and concentrates his law practice in personal injury and workers’ compensation law. He has tried over 100 workers’ comp cases to Opinion and Award and about a dozen personal injury jury trials to verdict. He has been board-certified by the North Carolina State Bar as a specialist in workers’ compensation law since 2001.
