On March 30, Governor John Kasich announced new opioid prescribing restrictions for acute pain. The limits, which must be adopted through administrative rule by the medical, pharmacy, nursing, and dental boards, will limit the use of opiates for the treatment of acute pain. Based on data from the Ohio Automated Rx Reporting System (OARRS), the state estimates an additional reduction of 109 million opiate doses once the new rules are in effect.
The limits are NOT currently effective and will not be effective until adopted by the state licensing boards. The Governor has been quoted as saying adoption of rules implementing his restrictions are a “done deal.” The rules are expected to take effect sometime this summer.
On April 3, the State of Ohio Board of Pharmacy issued a frequently asked questions (FAQ) document providing addition information about the governor’s proposed rules.
- No more than seven days of opiates can be prescribed for adults;
- No more than five days of opiates can be prescribed for minors;
- The total morphine equivalent dose (MED) of a prescription for acute pain cannot exceed an average of 30 MED per day;
- Health care prescribers can prescribe opiates in excess of the new limits only if they provide a specific reason in the patient’s medical record. Unless such a reason is given, a health care prescriber is prohibited from prescribing opiates that exceed Ohio’s limits;
- Prescribers will be required to include a diagnosis or procedure code on every controlled substance prescription, which will be entered into Ohio’s prescription monitoring program, OARRS;
- The new limits do not apply to opioids prescribed for cancer, palliative care, end-of-life/hospice care, or medication-assisted treatment for addiction;
- The new limits will be enacted through rules passed by the State Medical Board of Ohio, the State of Ohio Board of Pharmacy, the Ohio State Dental Board, and the Ohio Board of Nursing.