Stories of the horrors of opiate over-prescription and abuse are abundant, and Maine has not been spared the ravages of that epidemic. In response to the growing problem, Governor LePage, in April of this year, signed into law a bill intended to place some limits on the prescription of opioids in situations involving both “acute pain” and “chronic pain”. Under the new law, health care providers will be limited to prescribing no more than a 30-day supply of opioid medication in any 30-day period for patients with chronic pain. However, there is no limit on the number of times that a 30-day prescription can be written by a provider. The practical impact on chronic pain patients in the workers’ compensation system will be one of two outcomes: either, patients will now have to visit their providers every 30 days rather than the every three to six months schedule typical in long-term workers’ compensation chronic pain cases; or providers will be decreasing the number of opioid prescriptions issued to chronic pain patients as their practices suffer from limits on the ability to accommodate every-thirty-day appointments for medication renewal.
Already the author has heard knowledgeable members of the workers’ compensation bar suggest that the impact may be to encourage more chronic pain patients to taper opioid doses and seek alternative pain relief medication, such as medical marijuana. The positive aspect of that scenario is that more of the medically-challenging cases may then be better postured for a final settlement, releasing the injured worker from the workers’ compensation system while simultaneously putting more settlement money into the worker’s pocket, as the requirement of a Medicare Set-Aside would be drastically reduced. However, only time will tell what the impact may be on the Maine workers’ compensation system as it will undoubtedly take time for chronic pain patients and their providers to both comprehend the new limits on opioid prescription, and design the best path forward toward a productive, pain-limited life.