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Opioid Crisis

Burdine & Brown March 26, 2019

Is there an opioid epidemic in Georgia and the United States in general? The answer is an emphatic yes, and everyone would agree from the CDC to the American Medical Association to even our Legislature and Medical Professionals. The question is, how do we take care of this problem? In the workers' compensation system, the Employer/Insurer must provide medical treatment that is reasonable and necessary. They Employer/Insurer cannot suspend a client's weekly disability checks just because they did not engage in a medical procedure that would be deemed dangerous, intrusive, or unlikely to restore the employee to work. No Georgia Court, especially the workers' compensation board, has ever required the injured worker to undergo surgery. It should be that way.

However, what is reasonable and necessary in terms of medical care. Does opioid usage qualify as continuing necessary and appropriate treatment. The CDC has stated that opioid “are not the first line or retained therapy for chronic pain.” The CDC guidelines indicate that three days to one week is the maximum necessary limit for the use of opioid medicine and usually that is reserved for immediate, post-surgical pain relief.

There is a move afoot in different states to create a law that would be generally titled ‘medical treatment guidelines.' This would require, or dictate, or demand of the doctor that he or she give opioids only for a limited amount of time. This would virtually eliminate the option that pain management doctors have for treatment. Employers and Insurers do not like the ever escalating costs of pain management treatment and so their motive is to create legislation that would eliminate pain management as a treatment option.

So now, we have eliminated opioid usage (in theory) and now we have created medical guidelines for treatment (in theory) and essentially what we have is the Employer and the Insurer taking over the treatment of an injured worker in a workers' compensation claim. This is ridiculous. This has not happened and should not ever happen.

Legislation was beaten back over the last two years when introduced into the Georgia Legislature with regard to medical treatment guidelines. It should remain that way. I do acknowledge a huge problem: Since 2009 more than $800,000,000 in medical benefits alone is paid every year by Georgia Employers, their Insurers and self-insured funds. This information is taken from an article in the Georgia Bar Journal, December 2018, authored by Daniel Kniffen and Robert Ingram where they cite the State Board of Workers' Compensation statistics.

While the cost of treatment is high, handcuffing the doctors and the patients as to what type of treatment they can get is NOT the right answer.

Interestingly, the Georgia House of Representatives has approved a bill that would allow medical marijuana to be sold to registered patients. This legislation passed on a 123-40 vote would permit growing, manufacturing, testing and distribution of marijuana. However, marijuana would remain illegal for recreational use. This house bill has now been turned over to the Georgia Senate and if approved, Georgia would join 31 states that already has some form of marijuana cultivation.

To date, it is legal for patients suffering from severe seizures, deadly cancers, Alzheimer's, Parkinson's disease, and other diseases to use medical marijuana oil (CBD oil with THC content of 5% or less) since 2015. Last year, in 2018, Post-Traumatic Stress Disorders and intractable pain were added to the list of conditions eligible for treatment by cannabis oil.

There are some alternatives, but we need to let the free market define those alternatives once the legislature gives authorization for the marijuana uses mentioned above. We should not try to curtail or stop certain medical treatment by legislative means. Treatment should be administered by a doctor only in a doctor/patient relationship. Let's hope it stays that way.