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States turn to medical treatment guidelines for injured workers

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Washington state's “Interagency Guideline on Opioid Dosing for Chronic Non-cancer Pain” is among the respected medical guidelines doctors look to for determining appropriate treatment for injured workers.

Some states that require doctors to consult the treatment recommendations, such as Washington, publish their own guidelines, while others turn to national vendors.

With addiction, overdose, and death risks in mind, Washington's guidelines recommend urine drug testing of patients taking opioids for chronic noncancer pain in order to “identify aberrant behavior, undisclosed drug use and/or abuse, and verify compliance with treatment.”

The guidelines describe aberrant behavior as losing prescriptions, requesting multiple early refills, unauthorized dose escalation and apparent intoxication.

It may also be useful for doctors to order an “expanded drug urine” panel to look for use of other drugs such as cocaine, amphetamines, barbiturates and alcohol, according to the guidelines.

“While illicit drug use is unrelated to an industrial injury, it impacts the treatment and outcome of the injury,” said Jaymie Mai, pharmacy manager for Washington State's Department of Labor & Industries.