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Written by: Lindsay A. Underwood and Tracey L. Jones
As opioid use continues to plague the community, as part of the workers’ compensation system and otherwise, North Carolina is one of many states working to take steps to reduce availability and use of prescription pain killers. Per the North Carolina Opioid Action Plan (2017-2021), prepared by the Prescription Drug Abuse Advisory Committee (PDAAC), unintentional opioid-related deaths totaled 1,194 in 2016. Drug overdoses have become the leading cause of death among Americans under the age of 50. Further, it is estimated that more than two million people are dependent on opioids. In light of this epidemic, North Carolina Governor Roy Cooper has released an action plan to reduce the number of opioids being prescribed, increase community awareness and prevention, and expand other treatment and recovery systems.
As part of this policy overhaul, Governor Cooper recently signed into law a bill that regulates pain medication prescriptions. The bill, titled the STOP, or Strengthen Opioid Misuse Prevention, Act, limits physicians from prescribing more than a five-day supply of opioids during an initial visit. Though this provision does not apply to people receiving treatment for chronic pain, or a life-threatening condition like cancer, it does significantly limit immediate access to pain medications in the emergency department, where many individuals, including workers’ compensation claimants, seek initial treatment.
In an effort to reduce opioid-related deaths, the Food and Drug Administration (“FDA”) recently recommended that Endo International, P.L.C., withdraw its long-lasting opioid painkiller, Opana ER, from the market. This request is the first time an agency has called for the removal of an opioid painkiller for public health reasons, and could mark a turning point in how the FDA views painkillers. It should be noted that an FDA panel of advisors made this recommendation after determining the risks of Opana simply did not outweigh its benefits.
It is clear that policymakers across the board are recognizing opioid use as an epidemic. Notably, the North Carolina Industrial Commission recently appointed an Opioid Task Force to study and recommend solutions for the problems arising from the intersection of the opioid epidemic and related issues in workers’ compensation claims. In the workers’ compensation setting, medication use and costs are often a barrier to facilitating a return to work, and to claim closure. Further, the cost of opioids makes it extremely difficult to obtain a reasonable Medicare Set-Aside, where Medicare issues are at play. Ideally, these new limitations on medications will help reduce claim costs and facilitate rehabilitation and return to work.