See, New York State Workers’ Compensation Board, Mid And Low Back Injury Medical Treatment Guidelines, Third Edition, September 15, 2014, Section D.7.g.  Pursuant to section D.7.g.i, routine use of opioids for acute, subacute, or chronic pain is not recommended.  However, the Guidelines do provide for limited use of opioids in acute situations when there is severe pain and, in conjunction, two or more efficacious treatment modalities.  