Ohio issues painkiller guidelines

Every year, prescription painkiller overdoses kill more Ohioans than overdoses of heroin.
Tom Jackson
Oct 8, 2013


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.


Stop It

Therein lies the problem and the pandemic we are currently facing. The doc prescribes high dosages and doesn't realize how addictive they become. When doc finally sees it has gotten out of control in the patient's respect, he just cuts it off. Too late. Now you have someone addicted. They will soon be hitting the streets to find pills and finding out how expensive they are on the black market. Then comes heroin. Cheaper, better, faster. Supporting this habit leads to stealing and whatever because this person is incapable of working...


Stop It...the doctors DO NOT get patients addicted to narcotics. It is the people who take them. Common sense...oh wait, people lack common sense today. People are always looking to blame someone else for their faults. GROW UP PEOPLE!!! Got to start fixing this problem somewhere!


I do not see why people get addicted to painkillers, I have yet to find one that WORKS. I do not get a "high" from any pain killer. And yes I have been given HIGH doses from the doctors. Take enough to put an elephant down. But when I do hurt and try to get relief, ER doctors look at you like an addict. People who live with chronic pain are NOT DRUGGIES.....chronic pain is a different beast. When the ER doc offers me a couple of vicodin I usually tell him to keep them and go home. As long as he tells me my xrays are clear and I am not in fear of dying from something. Thanks to the druggies though, it is impossible to get access to anything that DOES work. The hoops you need to jump thru and the paperwork the insurance companies demand is ridiculous.

Stop It

UK...You have no idea of what you speak of. It obviously hasn't happened to you or anyone you know. What I typed was from my own life experiences, not statistics. Not only did it happen to ME, I watched two others I cared very much about die from overdose.

I had to take opiate based painkillers after an operation. The doc scheduled it so I would be weened off within a year!? I quit myself by shuttering myself after three months from everything for ten days just eating soup and drinking gatorade and having hot/cold sweats and MANY trips to the bathroom. I actually thought about suicide and I'm not built that way. Don't tell me what docs do and don't do.

After I quit on my own, my family physician for twenty one years dropped me because I did not follow his orders and I quit early.

2cents's picture

The ratios are about the same? The numbers are higher, is it better reporting or just more junkies being created? What a mess!


If it is a Chronic pain issue your family physician or pain doctor should be managing it with the "higher doses." If it is chronic it usually is not an EMERGENCY. So go to the physician who is more familiar with you...not the EMERGENCY room.


If you have "chronic pain" then your physician should be referring you to a LIGITIMATE pain doctor...not one of the pain pill pushers...but one who actually KNOWS what they are doing. These people have alternate pain stopping methods besides giving you pills to take. We have a fine one right here in Sandusky who has offices in Norwalk, and Port Clinton. After a physical and RESEARCHING your background of pain problems, one of the doctors will discuss the different methods of pain control in their "arsenal" of control. I am currently using them. What a relief to not suffer any more and they are miracle workers as far as I am concerned.

You would not believe what a wonderful feeling it is NOT to have to go to the ER and be treated like a drug addict or to have to rely on my family doctor for pain pills that did little to nothing to relieve chronic pain that has been with me for YEARS after botched surgeries. There are alternatives. You just have to research them and be a little smarter. Do I have access to pain pills. Yes, if I need them. Do I need them. Not so much any more, which is a wonderful feeling as well. YIPEE for the TRUE pain management doctors.