On May 3, Governor John Kasich announced that he will implement new chronic pain prescribing rules that he says will help prevent chronic pain patients from becoming addicted to prescription painkillers.
The new rules for chronic pain do not set limits on what can be dispensed but instead are based on the strength of medications. Physicians will be required to re-evaluate patients’ opioid use at periodic “safety checkpoints.”
The first checkpoint will be at 50 morphine equivalent dose (MED). Prescribers will be required to re-evaluate the patient’s underlying condition causing the pain, assess function, look for signs of prescription misuse, consider consultation with a specialist, and obtain written informed consent.
The second checkpoint will be at 80 MED. Prescribers will have to do all of the things done at the 50 MED level plus obtain a written pain agreement and consider a Naloxone prescription.
The final checkpoint is 120 MED. At this dosage, prescribers are required to have a pain medicine specialist as a prescriber or consultant.
The rules will apply to the treatment of patients with sub-acute pain, a type of pain lasting between six and 12 weeks, and long-term pain, lasting 12 weeks or more. The rules do not affect hospice patients, patients being treated in hospitals, or patients already being treated for chronic pain unless their dosages increase.
The State Medical Board of Ohio, the Ohio Board of Nursing, and the Ohio State Dental Board have been charged with writing the rules to implement Gov. Kasich’s initiative. The rules are expected to take effect in fall 2018.