Ohio lawmakers push opioid prescription restrictions, online addiction counseling

http://www.cleveland.com/metro/index.ssf/2017/03/ohio_lawmakers_push_opioid_pre.html

COLUMBUS, Ohio — Prescription painkillers are responsible for the largest number of opioid overdoses in Ohio, and state lawmakers want to further restrict prescribing the highly-addictive pills.  

GOP lawmakers introduced companion bills in the House and Senate that would adopt national opioid prescribing guidelines, set dosage limits for opioids prescribed by dentists and primary care doctors and make addiction education and counseling available online.

Gov. John Kasich plans to announce on Thursday his own proposal to limit opiate prescriptions.

Ohio led the nation in opioid-related overdose deaths in 2014. Prescription drugs were responsible for about 22 percent of the 3,050 overdose deaths reported in 2015. Heroin and fentanyl were responsible for the majority of overdose deaths. 

Sen. Jay Hottinger, a Newark Republican, said the package of reforms will prevent more people from becoming addicted to opioids and later turning to more potent drugs. 

“We’re not going to be able to legislate our way out of this epidemic,” Hottinger said at a Wednesday news conference. “But this will save lives because it will slow the pipeline of addiction caused by overprescribing.” 

Hottinger co-sponsored the Senate bill with Sen. Bob Hackett, a Madison County Republican. Republican Rep. Jay Edwards of Nelsonville sponsored the House version.

Under Senate Bill 119 and House Bill 167: 

• Primary care physicians and dentists could only prescribe up to the equivalent of 50 milligrams of morphine per day in no greater than three-day supplies unless they complete several requirements. 
• To prescribe greater amounts and supplies, doctors and dentists would have to complete eight hours of training about opioids and addiction and doctors would have to provide treatment for addiction. Exceptions are made for hospice, nursing home, chronic pain and cancer patients.
• Addiction treatment centers or physicians treating patients for addiction must offer naltrexone, which blocks opioids’ effects on the brain, as an option. 
• State officials must make patient counseling and education available online. 

The Ohio State Medical Association, which represents thousands of physicians, supports efforts to address the opioid crisis, spokesman Reggie Fields said. But Fields said such guidelines shouldn’t be mandatory and doctors should have discretion to best treat their patients.

“While two individuals may have the same condition, what’s effective for one might not be for another,” Fields said. “We want to avoid locking physicians in a cookie cutter approach.”

Fields said Kasich’s proposal gives doctors flexibility to make a clinical diagnosis in  the best interest of the patient.

Opioid prescriptions have declined as the state has increased prescription reporting and cracked down on pill mills and doctor shopping. The Governor’s Cabinet Opiate Action Team, a panel Kasich established in 2011, released physician guidelines in 2013 and 2016 aimed at reducing overprescribing.

Between 2012 and 2016, the total number of opioid doses dispensed to Ohio patients declined by 20.4 percent — from a peak of 793 million pills to 631 million pills, according to the State Board of Pharmacy.  

Opioid prescriptions in Ohio down more than 20 percent over last 4 years

Fields said the state is turning a corner with prescriptions and should focus on making treatment more available.

A new law expanding addiction treatment options and limiting the amount of pills that can be dispensed to a 90-day supply takes effect April 6. 

The legislation is called the bill “Daniel’s Law,” after a Germantown man who died from an overdose. Daniel Weidle battled addiction for eight years before he died at age 30. Weidle had been seeking treatment, his father Scott said. 

“Ohio has the opportunity right now to take ownership of this issue and do everything in its power to become a leader in opioid prescription reform,” Scott Weidle said.

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