The State Medical Board of Ohio is accepting comments on proposed amendments to two existing rules and a proposed new rule that will limit initial opioid analgesic prescriptions for acute pain to five days for minors and seven days for adults. The rules also include a 30 mg morphine equivalency dosing (MED) average daily dose limit.
- Is amended by adding definitions for acute pain, MED, minor, extended-release or long-acting opioid analgesic, opioid analgesic, palliative care, and terminal condition.
- Is amended by adding a requirement that physicians and physician assistants must follow Rules 4729-5-30 and 4729-5-13, Ohio Administrative Code. This will include the requirement that prescriptions for controlled substances will need to include the diagnosis.
- Limits prescriptions for opioid analgesics to treat acute pain to no more than a seven-day supply for adults and a five-day supply for minors. If the physician determines that the pain is expected to persist for longer than seven days, the physician may prescribe for a longer period, but the reason for exceeding the limits and for prescribing an opioid analgesic must be documented in the patient’s medical record.
- Requires that the patient and the parent or guardian of a minor patient is advised of the benefits and risks of the opioid analgesic, including the potential for addiction.
- Allows for exceptions for prescriptions for opioid analgesics used to treat patients receiving hospice or palliative care, cancer and terminal illness, and medication assisted treatment for addiction.
The provisions of these proposed rules will be applicable to physician assistants through Rule 4730-2-07, Ohio Administrative Code, Standards for Prescribing. The nursing and dental boards are promulgating rules with the same provisions. The State of Ohio Board of Pharmacy is promulgating rules consistent with these limits.
Comments must be submitted no later than Friday, April 28.
The Ohio Academy of Family Physicians will be submitting comments prior to the comment deadline, but individual members are encouraged to submit comments as well.