North Carolina has adopted its first set of rules regarding the use of opioids in workers compensation claims that will go into effect on May 1, 2018. The North Carolina Industrial Commission approved the adoption of nine permanent rules to be added to Subchapter 04 N.C.A.C. 10M regarding the prescription and use of targeted controlled substances on March 20, 2018. The new rules will only apply to claimants who received their first prescribed medications on or after February 7, 2018. Claimants who began opioid therapies prior to that time will not be covered by the new rules.

The new rules limit the prescribing power of treating physicians to order long-term opioids without giving significant consideration to the possible harm those drugs may cause. The rules also give employers and carriers the power to help resolve the opioid crisis by denying treatment that is outside of the rules. These rules consider the use of opioids in the first few days following the injury, the first 12 weeks, and the chronic phase. The rules also encourage physicians to consider non-pharmacological treatments for pain including physical therapy, chiropractic treatment, acupuncture, massage, cognitive behavioral therapy, biofeedback and functional restoration programs.

For new injuries (or new prescriptions of opioids in which there was not any prior opioid treatment), employers and carriers should carefully review the rules to make certain that positions are in compliance with the rules and that only treatment that follows the updated rules is authorized. A link to the new rules can be found here.

In addition, our firm’s summary of the rules and when denial of the prescriptions should be considered can be found here. https://www.gm-llp.com/wp-content/uploads/2018/04/Opioid-Rules-North-Carolina-2018.pdf

If you have any questions about these rules and how they apply, please do not hesitate to contact any of our North Carolina attorneys.