Prescription opioid and benzodiazepine use after road traffic injury

Background: Motor vehicle crash victims with physical injury are likely to receive prescription opioids and benzodiazepines. Potential mental trauma and lack of primary treating physician contribute to the risk of adverse opioid outcomes for this group. The purpose of this study is to characterise opioid and benzodiazepine prescribing after road traffic injury. Method: Individuals who claimed Transport Accident Commission compensation for a noncatastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for pharmaceutical benefits scheme (PBS) linkage were included (n5734). PBS records dating between 12 months preinjury and 18 months postinjury were provided by the Department of Human Services. Results: In the year before injury, 10.5% of participants received prescription opioids; after injury, 45.1% of hospitalized and 21.1% of nonhospitalized participants received opioids. Benzodiazepines were used by 4.8% preinjury, and 7.0% and 7.4% postinjury (with and without hospitalization, respectively). Postinjury, 39% of opioid use and 73% of benzodiazepine use was potentially unrelated to the injury. Conclusions: Prescription opioid and benzodiazepine before road traffic injury was substantial: the significance of postinjury prescription drug use cannot be established without taking preinjury use into account. It may be beneficial for pain medication to be managed by a pain treatment coordinator, in this injured population with high rates of preexisting opioid and benzodiazepine use.