CLEVELAND -- New regulations for the prescription of opioids for long-term pain will take effect in Ohio to combat the opioid crisis gripping the state.
The new rules, which take effect Sunday, require increased communication with patients and establish safety check points for physicians to reassess whether opioids are needed to treat pain lasting longer than six weeks.
The Centers for Disease Control reported nearly 50,000 opioid overdose deaths occurred in the U.S. in 2017, an increase from previous years. Most of those deaths involved painkillers.
Ohio leads the nation in opioid-related emergency room visits.
In 2018, the Cleveland Clinic reported a total of 2,832 opioid-related Emergency Department visits, including 1,006 overdoses.
“The state has recognized that we have a problem,” said Cleveland Clinic Pain Specialist Dr. Robert Bolash.
The new rules aim to increase patient awareness of the risk of opioid misuse and addiction by requiring doctors to discuss and document non-opioid treatments before starting long-term treatment. The rules also establish check points with requirements for varying doses of opioids. At certain dose levels, a pain specialist must be consulted or provide a treatment recommendation.
“Often times pain specialists can offer a number of different treatments aside from prescription opioid medicines in order to help people with pain,” Bolash said. “There are other medical options, there are other physical options, there are other injection options, there are other surgical options. There's a whole host of things that we can offer these patients.”
The new rules do not apply to patients with a terminal illness or those being treated in a hospital.
n 2017 the state implemented rules for acute, or short-term, pain prescriptions, limiting the amount of opioid medications that can be prescribed following something like a surgery.
“They're one more step that Ohio is taking to fight the opioid crisis,” said Kate Hickner, a partner with Kohrman Jackson & Krantz’s Healthcare Practice Group.
Hickner said KJK is helping doctors understand and comply with the new rules.
“The heart of the crisis is right here, and as a result Ohio has been very aggressive in imposing new regulations to help combat this public health crisis,” Hickner said.
Bob Garrity, Director of Risk Management for the ADAMHS Board of Cuyahoga County, said the rules are a step toward combatting the opioid crisis in addition to OARRS, the statewide prescription tracking system.
“I think it's one more tool in the toolbox,” he said. “We just have to continue to educate people.”
Garrity said he became addicted to opioids after being prescribed pain killers following a dental surgery as a teen and then working for his family pharmacy. Garrity, who has been in recovery for 17 years, later helped counsel others struggling with addiction.
“I think it's probably 40 to 60 percent of the people who end up getting opiate substance use disorders have started on pain medication that were prescribed or obtained from a family member or a friend,” Garrity said. “The OARRS system combined with these new guidelines will be one more way to educate doctors, basically, so they can pass that on to the patients.”