Ohio Strengthens Opioid Prescribing Guidelines in an Effort to Further Prevent Prescription Drug Abuse and Save Lives
January 20, 2016 - 1:00 AM
COLUMBUS — As part of Ohio’s
continuing effort to curb the misuse and abuse of prescription pain
medications and unintentional overdoses, the Governor’s Cabinet Opiate
Action Team today announced the adoption of new opioid prescribing
guidelines for the outpatient management of patients with acute pain
which is generally resolved within 12 weeks. Acute pain is typically
short-term and can result from injuries as well as surgical and dental
The new guidelines, which recommend
non-opioid treatment options when possible and limiting the amount of
opioids used to treat acute pain where appropriate, expand upon Ohio’s
prescribing guidelines for emergency departments and acute care
facilities, and for management of chronic pain lasting longer than 12
weeks. All three guidelines were developed by the Governor’s Cabinet
Opiate Action Team in conjunction with clinical professional
associations, providers, state licensing boards and state agencies.
“Too many families are being torn
apart by drugs and that is why we have been so proactive in exploring
new ways to prevent Ohioans from becoming addicted to prescription
opioids,” said Gov. John R. Kasich. “Building upon prescribing
guidelines we established for emergency departments and chronic pain,
these new protocols for treating short-term pain will strengthen our
efforts to fight abuse and ultimately save lives.”
In 2014, more than 262 million
opioid doses were dispensed in Ohio for the management of acute pain —
35 percent of the state’s 750 million total dispensed opioid doses.
Prescription opioids remain a
significant factor to unintentional drug overdose deaths in Ohio,
contributing to nearly one-half of all injury-related deaths in 2014.
“The new guidelines urge
prescribers to first consider non-opioid therapies and pain medications
for the management of acute pain when appropriate, to avoid the
potential misuse and abuse of opioids that can lead to addiction,” said
Dr. Mary DiOrio, medical director for the Ohio Department of Health.
“When opioid medications are necessary to manage a patient’s acute pain,
the guidelines recommend that the clinician prescribe the minimum
quantity necessary without automatic refills.”
“No prescriber can predict which
patients will become addicted to their opioid pain medication, so why
take the chance if the patient’s acute pain can be managed without
them?” said Dr. Amol Soin, a pain management specialist and vice
president for the State Medical Board of Ohio.
“Just because clinicians can
prescribe a 30-day supply of opioid medication doesn’t mean that they
should,” he said. “Prescribing only the amount necessary based on each
individual patient’s needs will help reduce the number of leftover
unused opioids and the potential for diversion and abuse.”
Dr. Soin noted that patients can
take an active role in keeping themselves and others safe. “When you
talk with your provider about managing your acute pain, ask to try
non-opioid pain medications and therapies first,” he said. “If you do
need opioid pain medication, then make sure that you store it securely
where nobody else can get it, and safely dispose of any leftover pills.”
Dr. DiOrio explained that, like the
emergency department and chronic pain prescribing guidelines, the new
acute pain guidelines encourage prescribers to check the State Board of
Pharmacy’s Ohio Automated Rx Reporting System (OARRS) before prescribing
an opioid. A review of OARRS is required for most opioid and
benzodiazepine prescriptions of seven days or longer.
“Patients may already be using
opioids or benzodiazepines from other prescribers,” she said. “Taking
these drugs together increases a patient’s risk of a drug overdose,
respiratory depression and death.”
Ohio is making it even easier for prescribers to check OARRS.
Last October, Gov. Kasich announced
an investment of up to $1.5 million a year to integrate OARRS directly
into electronic medical records and pharmacy dispensing systems across
Ohio, allowing instant access for prescribers and pharmacists. More than
110 hospitals, pharmacies and physician offices already have requested
Ohio’s opioid prescribing guidelines are having a positive impact in the fight against prescription drug abuse:
The number of prescriber and pharmacist queries using OARRS increased from 778,000 in 2010 to 9.3 million in 2014.
The number of individuals “doctor shopping” for controlled
medications decreased from more than 3,100 in 2009 to approximately 960
The number of opioid doses dispensed to Ohio patients decreased by almost 42 million from 2012 to 2014.
The number of patients prescribed opioid doses higher than
chronic pain guidelines recommend to ensure patient safety decreased by
11 percent from the last quarter of 2013 to the second quarter of 2015.
Ohio patients receiving prescriptions for opioids and
benzodiazepine sedatives at the same time dropped 8 percent from the
last quarter of 2013 to the second quarter of 2015.
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