Gov. John R. Kasich and representatives from the Governor's Cabinet Opiate Action Team (GCOAT) today announced the establishment of statewide guidelines to prescribe Opioids and Other Controlled Substances (OOCS) in emergency departments and other acute care facilities. Ohio now joins other national leaders like the state of Washington in narrowing this pipeline to prescription drug abuse.
The announcement was made during the afternoon kickoff of Ohio's 2012 Opiate Summit at the Hyatt Regency, with more than 250 health care professionals in attendance.
"This is a really big deal to be able to get the emergency rooms to agree that they're going to enter a protocol so that we're not going to allow people to go in there, get these prescriptions and be able to sell them," said Kasich. "This is a huge step, and I can't tell you how happy I am that the urgent care people raised their hands and said, "we want to be a part of it'."
In 2007, drug overdose became the leading cause of injury death in Ohio, surpassing motor vehicle crashes for the first time on record. This trend continued through 2010 when unintentional drug overdoses rose to their highest levels by claiming the lives of 1544 Ohioans. Prescription drug overdoses have largely driven this rise in deaths.
Emergency Departments (ED) is a major source of opiate prescriptions, with 39 percent of all opioids prescribed, administered or continued in the U.S. Nationally, opioid prescribing for pain-related ED visits increased from 23 percent in 1993 to 37 percent in 2005. In Ohio, 16 percent of fatal overdose victims in 2008 had a history of "doctor shopping" (filled prescriptions from at least five different prescribers in a year).
The OOCS guidelines include a general approach to prescribing but are not intended to take the place of clinical judgment, which should always be used to provide appropriate care. The set of guidelines include reminders to clinicians on what drugs to avoid routinely prescribing, as well as points to consider when making a determination on treatment options. In addition, companion guidelines were established to educate patients on these new pain management policies for acute care facilities.
"Prescription drug overdose deaths continue to be a public health crisis in Ohio," said state health department director Dr. Ted Wymyslo. "Today we are arming doctors and patients with important guidelines to protect the welfare of the public while still providing crucial pain medications to those in need."
The set of guidelines are the product of months of work by a subgroup of the opiate action team, led by the Ohio Departments of Aging and Health.
The various endorsers of the guidelines also play a significant role in clinical pain management prescribing practices in Ohio. Those who participated in the development of the guidelines and also endorse them are:
Ohio State Medical Association; Ohio Osteopathic Association; Ohio Chapter American College of Emergency Physicians; Ohio Hospital Association; Ohio Pharmacists Association; Urgent Care College of Physicians; Ohio Bureau of Workers Compensation; Ohio Physician Assistants Association; and Ohio Association of Health Plans.