What a new rule in Ohio means for people getting pain meds

What a new rule in Ohio means for people getting pain meds

https://www.cincinnati.com/story/news/2019/05/06/naloxone-opioid-prescriptions-chronic-pain-ohio-medical-board-rule/3564150002/

Do you or does someone you know have a pain pill prescription? Did naloxone come with the prescription?

More Ohioans can expect to discuss that option as a result of a new rule for doctors.

Doctors who regularly prescribe pain patients high doses of opioids are now required to talk to them about opioid safety, including the use of naloxone.

The State Medical Board of Ohio made the rule that went into effect late in December. It’s for patients receiving new, high-dose prescriptions for pain lasting more than six weeks.

“It is meant to safely manage pain,” said Tess Pollock, spokeswoman for the medical board. “We are not taking opioids away from patients who need them.”

Pollock said that’s something the medical board has been careful about during the opioid epidemic, which has been blamed in part on the overprescription of pain pills. The state continues to try to educate the public about the dangers of opioid medications, and the new rule is one way to prevent accidental overdose deaths, she said.

Naloxone is a non-narcotic that blocks the effects of opioids, restoring breathing in overdosing patients. Higher doses of pain pills, or even an extra pill taken by mistake, can induce overdose.

A recent survey shows that most Ohio pain-pills patients (81%) know if their prescribed medication is an opioid. Most (82%) have heard of naloxone. And most (70%) think it’s a good idea to have it around for safety. 

But among those surveyed, few had heard any of that from their physicians.

“We have strong majorities having heard of naloxone, but a small fraction had heard from their own providers,” said Doug Usher, a partner of the research group, Forbes-Tate Partners of Washington, D.C.

The survey wasn’t only for people who get high-dose pain-pill prescriptions, so respondents didn’t necessarily fit the profile of patients who fall under the state’s rule. The minimum strength for the rule is an 80 morphine equivalent dose.

Forbes-Tate surveyed 511 Ohioans in February who’d either been prescribed pain medication or had a family member prescribed it. The market research was commissioned by Adapt Pharma, the maker of Narcan, the brand for naloxone.

Thom Duddy, spokesman for Adapt Pharma, praised Ohio for creating the rule for doctors, noting, “There’s a significant percentage of patients out there that are at risk every day.”

He said Adapt Pharma’s concern isn’t just the prescription of Narcan. “I don’t care if they prescribe syringes and vials of naloxone instead of Narcan,” Duddy said.

The company has committed to the opioid-overdose fight, he said. In 2017, Adapt Pharma provided 25,000 free Narcan kits to Hamilton County alone as part of the region’s initiative to expand access to try to cut overdose deaths.

These days, chronic pain patients often are prescribed opioids at lower doses than that, said Dr. Harsh Sachdeva, who practices at UC Health West Chester and is the director of the pain fellowship program at UC College of Medicine.

“In our chronic pain practice, 70 percent of our patients are under that dose,” Sachdeva said. Patients get additional pain help, including spinal implants and psychological intervention. 

Regardless, Sachdeva said his patients are being prescribed naloxone as a safety measure to prevent unintentional overdose. 

Not all of them want it, he said.

“I hear it all the time. ‘Why are you giving it to me?’ ” Sachdeva said.

But Ohioans and others nationally might have to get used to the idea of having naloxone awaiting them at a pharmacy along with their pain pills.

The practice of prescribing the two together probably will become routine, medical professionals say.

Young doctors are being taught about the state rule, said Dr. Michael Binder, assistant professor of clinical medicine at UC College of Medicine.

But that’s not all:

“We’re teaching them to have a discussion with all patients about the risks and benefits of their opioid prescriptions,” Binder said. “That’s standard now.”

One Response

  1. Yeah, I’m sure if I overdosed I’d be able to squirt that up my nose. So ignorant

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