New Ohio opioid rules a model for the nation Drs. Oz & Roizen

Q: In one of your columns, you said docs and pharmacists were sometimes overreacting to the Centers for Disease Control and Prevention recommendations for curbing prescription opioid abuse. What guidelines could help patients who need pain relief while also helping to curb the abuse of these medications? — Kate S., Streetsboro, Ohio

A: That’s the big question, and people in health care, public health and government are working hard to find an effective approach.

In your own state of Ohio there’s been important progress. There are new rules and guidelines drawn up by your state medical board, the Ohio Board of Nursing and the state dental board. These guidelines require physicians to talk to patients about surgical, physical and injection options for pain management, not just medications, before prescribing an opioid pain reliever.

If opioids are prescribed, the use of them is assessed in relation to specific safety checkpoints that focus on the dosage and the length of time for which the meds are prescribed. After a person has received an opioid Rx for six weeks, the doc will be required to reassess the patient’s condition. When the prescription reaches a specific dosage level, the patient must be referred to a pain management specialist. There’s even a provision for supplying patients on high-dose opioids with the overdose-prevention drug Naloxone.

Ohio is leading the nation in finding smart ways to manage these medications, in part because it leads the nation in opioid-related emergency room visits. In 2018, Dr. Mike’s Cleveland Clinic alone reported a total of 2,832 opioidrelated emergency department visits, including 1,006 overdoses. The total cost in Ohio for opioidrelated medical interventions runs close to US$9 billion a year.

On a good note, Ohio has seen opioid prescriptions drop by 30 per cent (nationally the drop is 19 per cent), while doctor shopping has been nearly eliminated, in great part due to the Ohio Automated Rx Reporting System (OARRS). We believe OARRS and these new guidelines could become a national model, or a piece of one, that offers the quality care and protection every patient needs.