Ohio has made substantial progress under Gov. John Kasich in managing the distribution of the prescription painkillers that spawned an opioid and heroin epidemic that kills more than 2,000 Ohioans a year. But the state can do more by reducing so-called doctor shopping and getting patients who are struggling with addiction into treatment earlier.
The epidemic of addiction started in the 1990s, with an explosion of prescription drugs such as OxyContin, Vicodin, and Percocet. From the late 1990s to 2010, the distribution rates of prescription opioids in Ohio increased ninefold. So did the rates of fatal overdoses from these drugs. Managing this public health crisis will require systemic changes in how such painkillers are prescribed and monitored.
Last year, Ohio doctors prescribed 40 million fewer doses of opioids than they did a year earlier, according to state statistics. The number of patients seeking multiple prescriptions dropped to 960 last year, from 3,000 in 2009.
State-issued prescriber guidelines and wider use of the state Pharmacy Board's Ohio Automated Rx Reporting System (OARRS) deserve part of the credit. OARRS, an online patient database launched in 2006, enables physicians and pharmacists to cross-check prescriptions statewide. That reduces so-called doctor shopping by patients who are getting drugs from multiple prescribers. OARRS can also flag doctors who are overprescribing addictive opioids.
To expand the use of OARRS, the state will spend as much as $1.5 million a year to cover the costs of integrating the online database directly with electronic medical records maintained by doctors and pharmacists across Ohio.
Cross-checking prescriptions will essentially become a one-click operation. Ohio will be the first state to provide such integration of its prescription monitoring database, Cameron McNamee, spokesman for the State Board of Pharmacy, told The Blade's editorial page.
OARRS is an excellent tool, but it's only as good as the number of prescribers and pharmacists who use it. In 2013, 43,000 medical professionals wrote prescriptions, but only 20,500 were signed up for OARRS.
Today, nearly 36,000 prescribers have an OARRS account. Of the state's high-volume prescribers — those with more than 500 patients — 92 percent are on OARRS. The number of OARRS queries by pharmacists and prescribers rose from 778,000 in 2010 to 9.3 million in 2014.
Still, not all prescribers and pharmacists are signed up, and some who are haven't used the OARRS system as often as they should. OARRS access has been cumbersome for some medical professionals. But the state's new integration plan, if it is executed properly, should eliminate any excuses for not signing up for, or using, the state's online database.
An estimated 200,000 Ohioans are addicted to heroin or prescription painkillers. The epidemic has thrown families into turmoil and financial calamity, clogged the courts, and sent thousands of addicts to prison for drug-related crimes.
OARRS should be regarded not as a tool to catch abusers, but as a way to expand early intervention and treatment. Left unchecked, many people who abuse prescription painkillers eventually will turn to heroin — a cheaper and more potent drug.
Prescribers and pharmacists are on the front lines of Ohio's fight against opioid abuse. The state should be commended for making one of its most effective tools in the battle against addiction easier for them to use.
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