News rules by the Ohio Medical, Dental and Nursing Boards go into effect this week for prescribers using opioids to treat acute pain. The provisions of the new rules are designed to address overprescribing of opioid medications to reduce possible abuse and diversion.

In general, the rules limit the prescribing of opioid analgesics for acute pain to a seven-day supply for adults and a five-day supply for minors. Additionally, the total morphine equivalent dose (MED) of a prescription for acute pain cannot exceed an average of 30 MED per day. The limits do not apply to chronic pain, cancer, palliative care, end-of- life/hospice care or medication-assisted treatment for addiction.

“The rules have the potential to reduce the number of opioids prescribed for acute pain by an additional 109 million doses,” says State of Ohio Board of Pharmacy Executive Director Steven W. Schierholt. “These practical limitations on opioid prescribing will build on Ohio’s progress in reducing the overall supply of pain medications available for misuse and addiction.”

To help enforce the limited exceptions to the rules and enhance data regarding prescribing trends, 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. 

This provision goes into effect on Dec. 29, 2017, for all opioid prescriptions and June 1, 2018 for all other controlled substance prescriptions.

To assist in the implementation of these new rules, the State of Ohio Board of Pharmacy developed guidance documents for prescribers and pharmacists. Additionally, the State Medical Board of Ohio has also developed educational materials for prescribers, including a video overview of the rules.