Initial prescriptions of opioid painkillers for injured employees on workers’ compensation would be limited to a week or less, and workers would be asked to take urine tests before getting prescriptions for opioids to treat chronic pain.
The N.C. Industrial Commission, which is responsible for enforcing workers’ compensation laws, has proposed new rules aimed at reducing addiction and overdoses among injured workers. The package of nine rules would have injured workers use the lowest effective doses, and people with chronic pain would see their opioid prescriptions limited to 30 days at a time.
Urine tests would be required of injured workers prescribed opioids for more than 35 to 37 days. Their health care providers would have to determine whether those workers are at risk of overdose or other opioid-related health problems.
“Many injured workers are prescribed opioid medications as part of treatment for their injuries, creating an overlap between the opioid crisis and the workers’ compensation system,” Industrial Commission Chairman Charlton L. Allen said at a news conference Wednesday.
A study of people in the workers’ compensation system and opioid overdoses found that more than 800 people on workers’ comp died of an overdose over about four years. It’s not known whether or how prescriptions for pain medication contributed to the deaths, Allen said.
Among the proposals is for health care providers to consider prescribing a drug that reverses overdoses along with opioids in cases where employees are at risk of overdose.
Instead of drugs, providers would be able to prescribe physical therapy, acupuncture, massage, or other pain treatments.
Allen established a task force in February to come up with ideas for reducing injured workers’ risk of opioid addiction. The task force included injured workers, insurance carriers, lawyers, doctors, public health officials and Industrial Commission members.
Allen said the rules are consistent with the new state law that more closely regulates the prescribing of painkillers, called the STOP Act, and Centers for Disease Control guidelines for prescribing opioids. Other states’ worker compensation systems have developed guidelines for prescribing opioids, and Allen said the task force considered their changes.
The Rules Review Commission must approve the proposals and the Industrial Commission must adopt them.
North Carolina’s professional group for doctors, the N.C. Medical Society, applauded Allen and the task force “in their commitment to address the opioid epidemic within the North Carolina workers’ compensation system,” CEO and Executive Vice President Robert W. Seligson said in a statement.
“This is a complicated and multi-faceted problem with no simple solutions,” he said. “In the coming weeks, we will be reviewing the proposed rules with our members for clinical appropriateness. We look forward to sharing the physician perspective in the rulemaking process.”
A public hearing on the proposed rules is scheduled for March 2, and the Rules Review Commission is accepting written comments until March 19. The earliest the rules could go into effect is May 1.