The WSIB implemented opioid management to mitigate the risk that may arise from opioid therapy.
Our approach for opioid management allows initial prescriptions for select opioids with morphine equivalent dose (MED/MEQ) less than 90 for a maximum of 12 weeks. If opioid coverage goes beyond four weeks, it will be subject to clinical review. All opioids with morphine equivalent dose greater than 90 require authorization. If the patient continues to require opioid therapy, coverage may be approved for up to one year. The Nurse Consultant following the injured person’s recovery will send an opioid assessment form to the prescriber to gather the required information.
For long-term prescriptions, an opioid treatment agreement is required between the patient and prescribing physician, as the WSIB requires one prescriber-one pharmacy for all-opioid prescribing. We monitor for use of opioids together with benzodiazepines or other psychiatric drugs, and may impose additional limits to opioid dispensing to manage risks associated with chronic opioid use.
Refer to the McMaster guidelines to help in opioid prescribing. If a prescriber needs help managing chronic opioid therapy (e.g., tapering/switching of opioids, management of opioid-use disorder, sleep apnea, etc.), the WSIB can help with referrals to our Occupational Health Assessment Program (OHAP) or Specialty Programs for medication review.
The WSIB supports the provision of free naloxone kits for people on chronic opioids at risk of opioid overdose and their families. Naloxone kits are available free of charge in Ontario.
Treatment with buprenorphine/naloxone SL tablets (Suboxone®), buprenorphine extended release injection (Sublocade®), buprenorphine HCL subdermal implant (Probuphine®) and methadone is funded by the WSIB for people with moderate-to-severe opioid dependence from work-related injury/illness along with counseling and psychosocial support. See Non-formulary and prior authorization drugs for criteria.