Enhanced narcotics management for injured workers The WSIB is enhancing the way it manages cases for injured workers who have been prescribed narcotics (opioids) for non-cancer pain. The enhanced approach includes increased oversight of how narcotics support treatment goals, including improvement in function, quality of life, and safe and sustained return to work (RTW). Narcotics strategy The WSIB has developed a Narcotic strategy, which includes a graduated approach to narcotic management, with the goal of appropriate narcotic therapy for injured workers. The strategy includes new decision-support tools for WSIB clinical staff and enhanced WSIB physician discussion with prescribing doctors. Effective February 16, 2010, following a new injury or recurrence, the WSIB will initially only allow prescriptions for short-acting narcotics for a maximum of 12 weeks. Long-acting drugs will not be allowed during this period since there are other milder drugs available to workers for pain relief. After 12 weeks of ongoing narcotic use, WSIB clinical staff will review the worker’s case regarding the ongoing use. Workers with serious injuries or those with occupational diseases are excluded from this new approach. WSIB drug benefit program The WSIB began enhancing its drug benefit program in 2007. Based on that work, the WSIB formed a Drug Advisory Committee composed of external experts to provide recommendations on how best to manage the drug benefit program. At the same time, the WSIB also began identifying trends in the use of prescription narcotics (opioids) by injured workers. The trends show that 40 per cent more workers have been prescribed narcotics compared to 10 years ago. There have also been 100 per cent more narcotic prescriptions over that same time. Since 2006, the doses prescribed by physicians have also increased. The WSIB approach to narcotic therapy is based on two key principles: Authorization of narcotic (opioids) for workers should support treatment goals that include improvement in function, quality of life and safe and sustained return to work. A graduated approach to guide authorization of prescribed narcotics for the management of non-cancer pain that is consistent with best practice. Our goal is appropriate pain management. When used appropriately, narcotics should improve a worker’s function and quality of life, and support a safe and sustained return to work. Q&A See our Q&A for more information.