New Rules For Acute Pain Prescribing in Ohio

A few hours ago, the State Medical Board of Ohio announced new prescribing rules for opioid pain medications in the treatment of acute pain. These rules will take effect beginning on August 31, 2017. These new rules do not apply to the treatment of chronic pain.

Rules for prescribing for acute pain:

  • No more than seven days of opioids can be prescribed to adults
  • No more than five days of opioids can be prescribed to minors, unless written permission from parent/guardian
  • Can prescribe beyond day supply limits only if documented in medical record
  • Total morphine equivalent dose (MED) cannot exceed 30 MED per day
  • New rules do not apply to opioids prescribed for cancer care, palliative care, and hospice care

The State of Ohio Board of Pharmacy has a table of MED doses at this link. I also encourage you to check out the State Medical Board of Ohio links to Acute Pain Rules: Definitions, General Provisions, Prescribing of opioid analgesics for acute pain.

What does this mean? I know our "friends in Columbus" want physicians to write less opioid medication, but this is not the way to do it. Family Physicians like me will be more scared to write for opioid medications for my patients who will need it. Will I have to bring back my patients every seven days? According to the State Medical Board, when does acute pain transition to chronic pain?

In my opinion, these new rules will not help the opioid problem in Ohio. The unintended consequence will be that it will worsen the problem. Back in the 1990s, physicians were forced to address "Pain As The Fifth Vital Sign," which forced physicians to prescribe more opioid medication. Now, with the current opioid crisis, we are being legislated to write less. Will this drive patients to obtaining illegal opioids? The answer is yes, because you see it in the news everyday, especially here in Ohio.

What's the answer to the opioid problem in Ohio and across the country? I know it's complicated, but blaming doctors and putting more restrictions on physicians may get you some political points and help get/keep you elected. Meanwhile, according to the Columbus Dispatch, 4149 Ohioans died from unintentional drug overdoses in 2016, which is a 36 percent leap from the previous year. Plus, 2017 is on track to outpace last year's numbers. When are Ohioans themselves going to stand up and say that enough is enough?