Continuing to prescribe opioids in the absence of clinically meaningful improvement in function or after the development of a severe adverse outcome, or prescribing opioids in escalating doses to the point of the worker developing opioid use disorder is not considered proper and necessary care in the Washington state workers' compensation system (see WAC 296-20-01002 for the definition of proper and necessary care). Further coverage of opioids under these circumstances is not payable.