OHIO: New Limits on Prescription Opioids for Acute Pain

Subject: State of Ohio Board of Pharmacy Acute Prescribing Limits Update
Date: Fri, 18 Aug 2017 15:23:49 +0000

From: State of Ohio Board of Pharmacy <contact@pharmacy.ohio.gov>

Reply-To: PRX-noreply@pharmacy.ohio.gov


New Limits on Prescription Opioids for Acute Pain

Effective August 31, 2017, the State of Ohio will have new rules for prescribing opioid analgesics for the treatment of acute pain.

Please be advised, these rules DO NOT apply to the use of opioids for the treatment of chronic pain.

In general, the rules limit the prescribing of opioid analgesics for acute pain, as follows:
1. No more than seven days of opioids can be prescribed for adults.
2. No more than five days of opioids can be prescribed for minors and only after the written consent of the parent or guardian is obtained.
3. Health care providers may prescribe opioids in excess of the day supply limits only if they provide a specific reason in the patient’s medical record.
4. Except as provided for in the rules, the total morphine equivalent dose (MED) of a prescription for acute pain cannot exceed an average of 30 MED per day.
5. The new limits do not apply to opioids prescribed for cancer, palliative care, end-of-life/hospice care or medication-assisted treatment for addiction.
6. The rules apply to the first opioid analgesic prescription for the treatment of an episode of acute pain.
NOTE: These rules do not apply to veterinarians.

A guidance document and links to the rules for prescribers can be accessed here: www.pharmacy.ohio.gov/AcuteLimits.

Rule 4729-5-30 – Manner of Issuance
• Starting December 29, 2017, rule 4729-5-30 will require prescribers to include the first four characters (ex. M16.5) of the diagnosis code (ICD-10) or the full procedure code (Current Dental Terminology – CDT) on all opioid prescriptions, which will then be entered by the pharmacy into OARRS.
• Starting June 1, 2018, this requirement will take effect for all other controlled substance prescriptions.
• Starting December 29, 2017, rule 4729-5-30 will also require prescribers to indicate the days’ supply on all controlled substance and gabapentin prescriptions.
Effective December 29, 2017, rule 4729-37-05 requires the use of the ASAP Version 4.2A Standard for reporting dispensing information to OARRS. Pharmacies should begin contacting software vendors now to be able to implement this change by the effective date of the rule.

For additional questions regarding the proposed rules, please review frequently asked questions by visiting: www.pharmacy.ohio.gov/AcuteFAQ.

If you need additional information, the most expedient way to have your questions answered will be to e-mail the Board office by visiting: http://www.pharmacy.ohio.gov/contact.aspx.

State of Ohio Board of Pharmacy | 77 S. High Street, 17th Floor | Columbus, OH 43215-6126







6 Responses

  1. I am confused. I was at my pain specialists office yesterday. I don’t like going there but that is who I am with. I have had chronic pain for several years and currently taking 4 qty of 7.5 Norco and have been for some time. I also take muscle relaxers, gabapentin, Triazolam for sleep and several other meds.

    I have started having spine injections and yesterday I asked if there was a different brand of pain medication that may work better. She had told me we could try a different one if this one did not help. That as months ago.

    he told me I have to prescribe you less medication because of the Governor and new Ohio State Law. She said whereas I usually receive a 30 day supply of 120 gty tablets. I can, she can only write for 90 tablets?

    I read your article and it said chronic pain is not affected by this ruling? Can you tell me if chronic back problems/pain that is well documented and has been for years is considered chronic pain or acute. I have the pain 24/7 it is just a matter of to what degree I hurt at any given time but there is always pain. Sometimes debilitating and I have home health care.

  2. So what would they.consider a first.time? Someone like me who has had several rounds of acute pain due to.chronic kidney stones? Or someone who absolutely has never ever been prescribed an opiate in their entire life? I usually get Norco 5s 1-2 q 4-6h 40 of them.or 7.5s 1 or 2 q 6 depending on how big the stone looks.on the.scan and it takes 3 or.4 weeks.to.pass. I really hate wishing bad things on anyone, but those who vote on this crap may they have an 8mm kidney stone get stuck in their ureter and have to.have it taken out and have to have a stent placed in that ureter for at least post.op a week (pain worse.than the stone) then maybe they’ll have some idea what many of us go.through….and no pain meds or just Tylenol. I have already been called.a.drug seeker in the ER while my stone was lit up brightly on the scan…yeah I was in cahoots with the radiologist to paint it on there

  3. Steve,,,how much is 30 med a day?????These laws have nothing to do w/.our welfare,,truly,,,how is forcing human beings to endure physical pain helpful????its not,,,,,these laws are to arrest more dopctors,,more $$$$$,,,I thought is was awesome they excluded us cpp’s,,right??These laws do not apply to all us CPP,,,,IF i’m reading that right,,,maryw

    • 30 MED would be 6 – Vicodin 5 or 3 – Vicodin 10 per 24 hrs

      • thanku ,m

      • So who is going to go to the expense of and jump thru hoops for that if their pain is severe and 24/7?? That dose isn’t going to help those of us that have deteriorating conditions – what part of DIS-abled do they not understand??? How do we go sit in a waiting room and walk to exam rooms with no pain relief?? I already get complaints and looks because my pace is slow. For 30mg a day, I say pain drs and others are going to watch their bank account dry up. They want us to pour out $$$$$$ and jump thru hoops, then there has to be enough relief that we get some function. QOL – they already took that away for most. Why don’t they just set up the firing squad and be done with we horrible citizens who had the audacity to be chronically ill?? They need to call it what it is and take ownership of how cruel and inhumane this is. Not 1 consideration for anyone but addicts.

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