On March 30, 2017, Ohio Governor John Kasich and the executive directors of Ohio’s health care licensing agencies announced new opiate prescribing standards for acute pain. These regulatory limitations and standards follow voluntary guidelines and policies that have been established over the last several years. Not satisfied with the pace that such guidelines and policies have been adopted by Ohio prescribers, Governor Kasich and Ohio regulatory agencies are now going to mandate adherence to new national standards created by the Center for Disease Control and Prevention (CDC) last spring. i
While not yet fully drafted by Ohio’s health care licensing agencies, the new opiate prescribing limitations will incorporate the following:
1. Adults may only be prescribed seven days of opiate medication for an acute pain condition;
2. Minors may only be prescribed five days of opiate medication for an acute pain condition;
3. Total Morphine Equivalent Dose (MED) of a prescription for acute pain may not exceed an average of 30 MED per day;
4. Authorized health care providers may prescribe opiates in excess of the aforementioned limitations only if a specific reason is cited and documented in the patient’s medical record;
5. Authorized health care providers will be required to use a diagnosis or procedure code on every controlled substance prescription, which will be entered into Ohio’s prescription monitoring program, also referred to as OARRS; and
6. The new limitations will not apply to opiates prescribed for cancer, palliative care, end of life / hospice care or medication-assisted treatment for opiate or heroin addiction.
It is expected that the new rules will be drafted and passed by the State Medical Board, Board of Pharmacy, Board of Nursing and Dental Board relatively quickly. In the interim, licensed prescribers should be aware of the CDC’s guidelines and promptly implement them into their practices.