Date: December 1, 2010
Concerns have been raised that claimants on long term narcotics and other pain medications will have their medications discontinued because of recommendations in the Medical Treatment Guidelines (MTG). This is not true. Claimants who have been receiving long term narcotics and/or other pain medications prior to December 1, 2010, should continue to have their prescriptions paid for by carriers and filled by pharmacies.
The Guidelines state that "Narcotic medications should be prescribed with strict time, quantity, and duration guidelines and with definitive cessation parameters... [with a] Maximum duration: 2 weeks." The Guidelines further state: "Use beyond two weeks is acceptable in appropriate cases. Any use beyond the maximum should be documented and justified based on the diagnosis and/or invasive procedures"
It is critical to note that the MTG do not require, and are not intended to recommend, the immediate cessation of prescription narcotics or other medication for claimants who have been using such medication long term. There are very significant health risks associated with the sudden withdrawal of narcotics and other pain medications. The MTG allow for the use of pain medication beyond the maximum duration. Therefore, carriers should continue to pay for these medications without a variance request.
For workers with injuries for which the initial prescription of narcotics and/or other types of pain medications is being considered on or after December 1, 2010, it is expected that the physicians will prescribe these medications consistent with the MTG. In cases where the need for continued pain medication beyond two weeks is documented and justified, a variance is not required.
Further guidelines on the long term use of narcotics and other pain medications will be developed by the Board in the near future.
Robert E. Beloten