In 2018, Governor Wolf announced a set of opioid prescribing guidelines to assist health care providers in treating workers’ compensation patients. Highlighting the need for reform and the need to combat increasing opioid addiction, the guidelines include recommendations for the treatment of acute, sub-acute, post-operative pain, and chronic pain.
Treating work-related injuries, as well as helping injured workers return to work as soon as possible is one purpose of Pennsylvania’s Workers’ Compensation Act (WCA). Effectively treating both acute and chronic non-cancer pain typically involves the use of multimodal pain treatment methods. It is important to properly treat acute pain to lower the risk for the development of chronic pain.
In the last few decades, opioids have been used for the treatment of both acute and chronic pain, but many have questioned the need for its extensive use based on the resulting opioid epidemic that is taking place in America in 2020.
The increased use of opioids throughout the United States has contributed significantly to the current deadly epidemic. In 2016, there were 64,000 opioid overdose deaths nationally, and 4,642 in Pennsylvania. This equates to approximately 13 individuals across Pennsylvania daily and represents a 37 percent increase over the number of deaths that occurred in 2015.
Governor Wolf stated: “[i]n 2017, there were more than 174,216 workers’ compensation claims made in Pennsylvania, and our state ranks third highest in the nation in the percentage of injured workers who become long-term opioid users.” Further, the Administration reported that workers who received longer-term opioid prescriptions for work-related lower back injuries had a substantially longer duration of temporary disability. The average lost-time claim for injured workers, prescribed with opioids, is 900% higher than that of injured workers who were not prescribed these drugs.
The Wolf Administration identified the following objectives for the guidelines:
- To promote the delivery of safe, quality health care to injured workers;
- To ensure patient pain relief and functional improvement;
- To be used in conjunction with other treatment guidelines, not instead of other recommended treatment;
- To prevent and reduce the number of complications caused by prescription medication, including addiction; and
- To recommend opioid prescribing practices that promote functional restoration.
The Wolf Administration released a detailed seven-page instructional booklet on how health care providers should approach treatment for conditions resulting from work-related injuries. In summary, the guidelines recommend that opioids should be prescribed only in combination with other treatment options, at the lowest dose, and for the shortest length of time possible.
Governor Wolf’s official actions related to these guidelines signal Pennsylvania’s response to a serious problem in America. However these are only guidelines. They are not legally binding and are intended only to supplement, not replace clinical judgment. Health care providers who follow these guidelines may help promote safe and effective treatment for injured workers to help them return to work as soon as possible in the best possible health.
The process for filing and receiving approval of workers’ compensation claims in Pennsylvania is complicated. Claimants are required to provide a long list of information in the form of medical records and other necessary documentation. This information must be collected, organized, and presented within certain procedures and deadlines.