Today’s post comes from Kristina Thompson at the Jernigan Law Firm.

North Carolina Industrial Commission Adopts Opioid Rules and Companion Guide

This blog is a follow up to my blog from February 2017 about the North Carolina Industrial Commission’s Opiod Task Force. As mentioned in that blog, the CDC noted that opioid sales had quadrupled since 1999. To address the opioid crisis, new rules about opioids were adopted by the Industrial Commission on May 1, 2018. The rules are intended as guidance for the “intersection of the opioid epidemic and related issues in workers’ compensation claims” (quoting Chair Allen’s Opioid Task Force statement of February 2017).

In summary, here are a few points under the new rules:

  1. They are effective immediately to all injured workers in North Carolina under the Workers’ Compensation Act.  However, there is an exception for employees on an ongoing opioid treatment plan for more than 12 consecutive weeks immediately preceding May 1, 2018.
  1. They are not medical advice or a standard of medical care.
  1. They apply to select controlled substances like opium, codeine, hydromorphone, morphine, oxycodone, oxymorphone, fentanyl, methadone, and others.
  1. They require health care providers to consider co-prescribing an opioid antagonist in certain situations (i.e. substance abuse disorder). Opioid antagonists block opioid receptors in the brain (e.g. nalogone or naltrexone) and are effective in treating substance use disorders.
  1. They require health care providers to consider non-pharmacological treatments for pain like: physical therapy, chiropractic services, acupuncture, massage, cognitive behavioral therapy, biofeedback, and functional restoration programs.
  1. Health care providers may refer employees for an evaluation for discontinuation of a substance or for treatment for substance use disorder.
  1. Waiver of the rules is possible upon written application of a party or upon the North Carolina Industrial Commission’s own initiative.