North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 23 - INDUSTRIAL COMMISSION › Subchapter M - RULES FOR THE UTILIZATION OF OPIOIDS, RELATED PRESCRIPTIONS, AND PAIN MANAGEMENT TREATMENT IN WORKERS' COMPENSATION CLAIMS › Section .0100 - GENERAL PROVISIONS › Section 23M .0102 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
As used in this Subchapter:
(1) "Acute phase" means 12 weeks of treatment
				  for pain following an injury by accident, occupational disease, surgery for an
				  injury by accident or occupational disease, or subsequent aggravation of an
				  injury by accident or occupational disease. There may be more than one acute
				  phase during treatment for an injury or occupational disease.
(2) "Chronic phase" means continued treatment
				  for pain immediately following a 12-week period of treatment for pain using a
				  targeted controlled substance.
(3)
				  "Confirmatory urine drug test" means a definitive urine drug test that verifies
				  the results of a presumptive urine drug test. A confirmatory urine drug test
				  identifies individual drugs and drug metabolites. Health care providers shall
				  use a confirmatory drug test for the lowest number of drug classes necessary
				  based on the results of the presumptive urine drug test, not to exceed 21 drug
				  classes.
(4) "CSRS" means the
				  Controlled Substances Reporting System as established by the North Carolina
				  Controlled Substances Reporting System Act, Article 5E of Chapter 90 of the
				  North Carolina General Statutes.
(5) "Long-acting opioid" or "extended-release
				  opioid" means any targeted controlled substance that is formulated to release
				  the drug gradually into the bloodstream or to have a long half-life for
				  prolonged activity with an analgesic effect of 8 to 72 hours or
				  longer.
(6) "Lowest effective
				  dosage" means the lowest dose necessary to achieve the clinical goal.
(7) "Morphine equivalent dose" means
				  conversion of various opioids to an equivalent morphine dose by using the most
				  current conversion guidelines provided by the Centers for Disease Control and
				  Prevention ("CDC"). The CDC Opioid Prescribing Guideline Mobile App and the
				  CDC's guidelines for Calculating Total Daily Dose of Opioids for Safer Dosage
				  are hereby incorporated by reference, including any subsequent amendments or
				  editions. These materials are available online at no cost at
				  https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf and
https://www.cdc.gov/drugoverdose/pdf/App_Opioid_Prescribing_Guideline-a.pdf
.
(8) "Opioid antagonist" means the
				  term as defined in
				  G.S.
				  90-12.7(a).
(9) "Pain" means pain resulting from an
				  injury by accident or occupational disease.
(10) "Presumptive urine drug test" means an
				  initial urine drug test that identifies negative specimens and presumptive
				  positive specimens, and is interpreted through visual examination. Examples
				  include dipstick tests and drug test cups. A health care provider who is
				  providing pain management treatment in the chronic phase to an employee may
				  administer a presumptive urine drug test that is qualitative and interpreted or
				  analyzed with instrumental or chemical assistance if the health care provider
				  believes, in his or her medical opinion, that a more sensitive presumptive
				  urine drug test is appropriate and is likely to reduce the need for a
				  confirmatory urine drug test.
(11)
				  "Short-acting opioid" means any targeted controlled substance with a quick
				  onset of action and short duration of analgesic activity that is formulated for
				  dosing at intervals of two to six hours.
(12) "Targeted controlled substance" means
				  any controlled substance included in
				  G.S.
				  90-90(1) or (2) or
				  G.S.
				  90-91(d).
Authority
					 G.S.
					 97-25.4;
					 97-80(a); S.L.
					 2017-203, s. 4;
Eff. May 1, 2018;
Recodified from
					 04 NCAC
					 10M .0102 Eff. June 1,
					 2018.