A study of workplace injuries in 27 states, including Missouri and Illinois, shows 68% of injured workers in very rural areas received at least one opioid prescription, while 54% of their urban counterparts received the same amount of prescription.
The study was conducted by the Workers Compensation Research Institute, an independent group that does research for insurance companies, employers and labor unions.
Vennela Thumula, a policy analyst at the institute who authored the study, said it’s difficult to know for sure why the discrepancy exists. She said one possibility is the difference in access to health care.
“It is possible that in rural areas there are fewer specialists compared to urban areas, which might be one of the factors,” Thumula said.
Patients in rural areas may be getting more painkillers as a stopgap until they can see a specialist, who may be far away.
Michael Boeger, chief of the Missouri Bureau of Narcotics and Dangerous Drugs, agrees with that. He previously worked investigating workers' compensation claims, and said he often saw doctors giving out painkillers to injured workers until they could see a specialist. For rural workers, specialists could be many miles away, and appointments would take longer to get.
But Boeger said the report doesn’t consider all of the factors facing rural workers hurt on the job. For example, he said, workplace injuries in rural areas are often more severe.
“They might have a broken back, they might have had a limb or an arm caught in some farming equipment, they might have been ran over by something, they might have been crushed in a cave-in,” Boeger said. “The more severe the injury, the more pain there is, the more the doctors are going to have to address it.”
The study’s author said they removed as many variables as they could.
"We controlled for the age composition of the injured workers, we controlled for industry mix,” Thumula said. “So we controlled for several of those characteristics and we still see these differences across urban versus rural areas.”
Thumula said the study can be a tool for people who are looking to fight the opioid problem. Boeger said the study isn’t of that much help in Missouri.
“Opioid abuse is a major concern in both urban and rural areas, and it needs to be addressed at the statewide level,” Boeger said.
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