Ohioans in long-term, chronic pain need not worry about the state taking away their painkillers, but medical professionals will have to comply with “safety checkpoints” to more carefully manage patients' use of opioids.
Gov. John Kasich and leaders of state health-care profession licensing boards Wednesday announced a series of “common-sense” thresholds of opioid use that will trigger increased monitoring to ensure patients are receiving appropriate, non-dangerous doses.
“Don't worry, you'll get what you need and get it in a more positive, more successful way,” Kasich said of the rules expected to be adopted this fall by the State Medical Board, Ohio Board of Nursing and Ohio State Dental Board.
Daily dosages of prescription opioid use, depending on the level, will require prescribers to re-evaluate underlying conditions causing pain, look for signs of prescription misuse and consult pain-care specialists.
The steps to re-examine painkiller use will not apply to terminally ill patients receiving end-of-life and hospice care.
“These are a responsible, realistic set of rules,” to help ensure pain patients are not receiving risky doses of opioids, with which the risk of death rises with dosage, said Dr. Robert Giacalone, medical board president.
Under new requirements that began Sept. 1, doctors, dentists and others were prohibited from prescribing more than seven days of opioids — five days for minors — for temporary treatment of pain. Refills can be prescribed only if physicians and others document the need for extending pain-relief medication. Painkiller prescriptions start many on the road to addiction to heroin and other opioids.
Reporting requirements for pharmacies and physicians and limits on opioid prescriptions have reduced the amount dispensed by 30 percent between 2011 and last year while deaths from prescriptions dwindled from 724 in 2011 to 564 in 2016.
“We have less chance of addiction than ever before,” the governor said.
On Feb. 1, Kasich proposed rules requiring drug distributors to report and halt suspicious orders of prescription painkillers. The rules would require distributors to detect — and not ship — suspicious orders of opioids to pharmacies and hospitals, such as orders that are large when compared to past purchases. The rules remain open for comment, but “we're getting close,” Kasich said.
While the number of prescribed opioids and related deaths are dropping, the availability of street drugs, particularly deadly fentanyl, continues to fuel a rise in illicit drug deaths.
According to the latest federal figures, Ohio recorded 5,231 drug deaths in the 12 months ending last September, an increase of 30.8 percent over the prior year. Only Pennsylvania (5,577) and Florida (5,516) had more drug overdose deaths than Ohio.
Preliminary figures from Franklin County show 520 drug deaths last year — two-thirds related to fentanyl — for a near-36 percent increase from 2016.
“I can't deal with street drugs” beyond asking the State Highway Patrol to continue efforts to capture couriers on the state's highways, Kasich said.