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New Ohio Law Puts More Restrictions on Prescribing Opioids. How Will It Benefit You?

Ohio’s Governor John Kasich, determined to get the prescription opioid disaster in his State under control, just signed another bill, one of many, restricting the prescribing of opioid painkillers. In 2014 prescription opioids caused 2,106 deaths – more than in any other State. In 2015, the deaths went up even more, to 2,590. Nevertheless, from 2012 to 2016, the number of opioid doses prescribed has been reduced by 20.4 percent. It is hoped that the new laws will further reduce the prescriptions written, reduce the deaths.

It’s interesting that despite the laws that have been passed over the last four years about prescriptions of opioids, and the number of doses prescribed being reduced by 22 percent, the deaths – at least until 2015 – have continued to climb. The numbers aren’t out for 2016, so we’ll see what happens then.

Still, why are the deaths going up when the number of pills being subscribed is going down? Perhaps there’s a hint in something Kasich said when the democrats protested that similar laws signed in January didn’t include any new funding. According to Cleveland.com , “Kasich said that the state spent $1 billion fighting drug abuse and addiction in the past year, and those efforts aren’t helpful if communities don’t use them.”

And maybe that is exactly the problem. Prescription drug monitoring programs – databases that contain info about prescriptions having been filled for a given individual and make it possible for doctors and pharmacists to check a person’s history before they write or fill a prescription – might be a good example. Checking the database may enable a doctor to identify an addict (or a dealer who’s selling his own prescription drugs) and have a chance to do something about it rather than just giving the person more drugs.

But only about half the doctors who have it available to them – and not everyone does – use it. And only 72 percent even know about them.

50 percent helps, but why pour more money into something else when you could put the focus – or force – behind getting those things utilized that have already been put in place?

The bill in January had a lot of punch. Possibly motivated by the deaths increasing in 2015. Among other things:

  • it waived the requirement of being certified in Ohio for two years before being able to prescribe methadone
  • allowed for-profit methadone clinics
  • allowed homeless shelters, halfway houses, schools, treatment centers and other facilities that regularly interact with high-risk individuals to keep naloxone on site in case of overdoses.
  • limited the number of pills that could be dispensed in a single prescription to 90
  • made prescriptions more than 30 days old invalid
  • and provided immunity to first responders and others authorized to administer naloxone. So, if someone overdoses, another person that’s with them doesn’t have to be afraid to callthe police or 911 for help. In the past, they would be prosecuted if they had any drugs on them or were suspected of other offenses.

The bill signed in a few days ago adds to that:

  • Unless primary care physicians and dentists complete certain requirements, they can only prescribe a total of 50 milligrams of morphine per day, and for no more than three days. (Except for hospice, nursing home, chronic pain and cancer patients.)
  • The requirements consist of eight hours of training about opioids and addiction – not much, but it’s certainly more they got in medical school – and the doctors would have to provide treatment for addiction. Something else they didn’t learn in medical school and don’t know a thing about.
  • Addiction treatment centers or physicians treating patients for addiction must offer naltrexone. Naltrexone blocks the effects of opioids on the brain and can reduce cravings and help a person through withdrawal.
  • Also, State officials must make patient counseling and education available online.

What this will do for addicts remains to be seen. Fewer opioids being prescribed will help. Doctors being trained on prescription opioid addiction and being trained to help treat it will help. Naloxone being more available will help reduce deaths – although most often, people who are ‘brought back’ after an overdose death go right back out there and do the same thing again. Still, some people will get drug rehab instead. And having Naltrexone on hand will help people get through withdrawal so they can get a start on rehabilitation.

I would say the next practical thing that could be done, in addition to making long-term residential treatment more available – since it takes months to get someone out of an addiction – would be to make alternative treatments to pain more available. Like get more insurance companies to cover more visits to chiropractors, acupuncturists, physical therapists, and others who can help without drugs and actually get down to the bottom of what’s causing pain and fix it.

It’s all a huge and long undertaking. But with the right strategy, it can certainly be much improved.

 

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