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Ohio issues painkiller guidelines

Tom Jackson • Oct 8, 2013 at 2:30 PM

State officials have taken a new step to try to curb deaths from prescription opiates. They’ve issued new guidelines to physicians for prescription prescription opiates to patients who have chronic pain but don’t have a terminal disease.

The guidelines ask doctors prescribing large doses of opioid painkillers such as hydrocodone and oxycodone to carefully consider whether they should continue.

Doctors are being asked to return to the traditional guideline in medicine to first do no harm, said Dr. Ted Wymyslo, director of the state health department and a member of the group that put together the new guidelines for the Kasich administration.

Fifteen years ago, Wymyslo explained, doctors were told they weren’t paying enough attention to pain. They responded by readily prescribing pain medications, Wymyslo said.

“We are trying to swing that pendulum back,” he said.

Doctors are being asked to visit a new website, opioidprescribing.ohio.gov, to learn about the new guidelines.

The new guidelines say that when chronic pain patients are being prescribed 80 milligrams of Morphine Equivalent Daily Dose, doctors should reevaluate the effectiveness and safety of the pain management plan. That represents a high dose — it’s the equivalent of 16 tablets of five-milligram doses of hydrocodone, for example, or 11 five-milligram tablets of oxycodone.

Patients who are taking high doses of painkillers are much more likely to suffer an overdose, officials said during a conference call with reporters.

The reporters asked if the new guidelines would make it harder for chronic pain patients to obtain the painkillers they need.

The health officials replied that the new guidelines are not mandatory rules and don’t replace a doctor’s judgment.

Jeff Smith, director of government relations for the Ohio State Medical Association, said some patients might suffer a temporary disruption, but said the idea is to take a collaborative approach rather than punishing doctors. Smith said the intent is to tell doctors they can still use their own judgment.

“No patient should be put in this position, based on what we have put forward,” Wymyslo said.

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