Here is the “guidelines” for Ohio and prescribing opioids for Non-Terminal Pain. I did a “word search” for PHARMACOGENOMICS TESTING and it did not appear once in these guidelines. So these guidelines appears to be created by one or more people who is still functioning with a 20th century medical mind set/education.
Just take a pt who has been diagnosed with Complex regional pain syndrome (CRPS) https://en.wikipedia.org/wiki/Complex_regional_pain_syndrome and is a ultra-fast metabolizer and will require high and frequent doses of a opiate, and they use the McGill Pain Scale and CRPS is known as the “suicide disease”
Notice this in Ohio’s guidelines, No absolute maximum dose or duration of treatment is established for patients already being treated for chronic pain. Does this mean that “legacy pts” get a “free pass” to stay on the opioid dose they have been stable on for a long time. But here is a blog post that I made last week Did you every wonder how many new chronic pain patients are created everyday? That number would be about 50,000 new chronic pain pts PER YEAR. I have never seen, but others may have – the number of chronic pain pts that die from a OD, suicide or premature death from under/untreated pain.
I wonder if all this limiting of prescribing, dispensing opioids is just some sort of weird process/prgm to help create a balance between the number of new chronic pts and existing chronic pain pts?
what is the policies of Ohio in prescribing opioids/opiates for treating chronic pain and what mme/day – if any – are written in stone
Ohio has implemented several policies and guidelines for prescribing opioids to treat chronic pain. The state has established safety checkpoints and regulations to ensure appropriate prescribing while minimizing the risk of opioid misuse and addiction[4].
Key points of Ohio’s opioid prescribing policies for chronic pain include:
1. Morphine Equivalent Daily Dose (MED) checkpoints:
– 50 MED: Prescribers must re-evaluate the patient’s condition, assess functioning, look for signs of misuse, consider specialist consultation, and obtain written informed consent[4].
– 80 MED: Prescribers must look for signs of misuse, consult a specialist, obtain a written pain-management agreement, and offer a naloxone prescription[4].
– 120 MED: Prescribing above this level requires a recommendation from a board-certified pain medicine physician or hospice and palliative care physician, based on a face-to-face examination[4].
2. No absolute maximum dose or duration of treatment is established for patients already being treated for chronic pain[4].
3. Prescribers must consider and document non-medication and non-opioid treatments before prescribing opioids for chronic pain[8].
4. The Ohio Guidelines for Prescribing Opioids for the Treatment of Chronic, Non-Terminal Pain use 80 mg MED as a “trigger threshold,” as the odds of an overdose are higher above that dose[7].
It’s important to note that while these guidelines and checkpoints exist, there is no specific MED/day that is absolutely “written in stone” for chronic pain treatment in Ohio. The regulations allow for clinical judgment and individualized patient care, particularly for those already on established treatment plans[4]. However, prescribers must follow the checkpoint requirements and document their decision-making process when prescribing higher doses.
Citations:
[1] https://doh.wa.gov/sites/default/files/legacy/Documents/2300/2017/OH-OK-OR-VermontPrescrib.pdf
[2] https://mha.ohio.gov/about-us/media-center/media-resources/opioid-prescribing-guidelines
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC9277518/
[4] https://med.ohio.gov/for-licensees/prescriber-resources/overview-regulations-for-chronic-and-subacute-opioid-prescriptions
[5] http://www.ooanet.org/aws/OOSA/page_template/show_detail/81290?model_name=news_article
[6] https://www.jpsmjournal.com/article/S0885-3924(22)00705-9/fulltext
[7] https://www.ohioafp.org/public-policy/state-legislative-regulatory-issues/opioid-prescribing-guidelines/
[8] https://www.mcmsoh.org/general/2021-12-19-safe-opioid-prescribing-in-ohio/
[9] https://spectrumnews1.com/oh/columbus/news/2023/09/22/prescription-opioids-pain-patients-
Ohio Governor Blocks Bill Allowing Doctors to Disagree with the Medical Opinions of State Officials
“Health professionals who give harmful medical care shouldn’t get a ‘legal shield’ to avoid accountability,'” Gov. Mike DeWine said.
Ohio Gov. Mike DeWine blocked a bill late Thursday that sought to protect medical professionals from disciplinary action for expressing opinions that contradict state health officials.
DeWine argued the measure in House Bill 315 would severely undermine the state’s ability to regulate medical misconduct and safeguard public health, AP reported.
“Ohio’s medical licensing boards exist to protect patients and the public from bad actors in the medical field,” DeWine wrote in his veto message. “Health professionals who give harmful medical care shouldn’t get a ‘legal shield’ to avoid accountability by claiming a difference of ‘medical opinion.'”
The provision, backed by Ohio Advocates for Medical Freedom, aimed to prohibit state health boards from disciplining licensed professionals for “publicly or privately expressing a medical opinion that does not align” with the “opinions” of health authorities at the city, county, or state level, AP reported.
Critics, including DeWine, warned it could have led to harmful consequences for patient care. The veto comes amid ongoing national debates over medical freedom and vaccine policies.
In 2021 an Ohio osteopathic doctor, Sherri Tenpenny, went viral for a testimony before state legislators where she claimed COVID-19 vaccines made people magnetic and could be interfering with women’s menstrual cycles and making people “interface” with cell towers.
In response to hundreds of complaints, the state medical board launched at inquiry and eventually suspended Tenpenny’s medical license when she refused to cooperate with the investigation. Ohio Advocates for Medical Freedom deny that Tenpenny’s case inspired the medical free speech proposal.
Despite vetoing the medical free speech provision, DeWine left other elements of the bill intact, including a declaration that Ohio is outside the jurisdiction of the World Health Organization (WHO).
Filed under: General Problems
The insanity never ends