Ohio ER policy aims to fight drug abuse

5/8/2012

COLUMBUS — Ohio has gotten emergency rooms to join the fight against the over-prescription of addictive painkillers.

Gov. John Kasich said Monday the next step, getting similar involvement from physicians across Ohio, will be tougher.

"They had a lot of problems out in the state of Washington on this, because there's a reluctance to let legislators or bureaucrats, cabinet officials or not, tell the doctor how to practice medicine," the governor said after speaking at the Ohio Association of County Behavioral Health Authorities' Opiate Summit.

He hopes to take statewide a fight that so far has largely focused on so-called "pill mills" in southern Ohio.

The administration unveiled a new protocol hospital emergency rooms have agreed to follow to restrict the prescription of addictive painkillers to patients who complain of pain. Thirty-nine percent of all opiate prescriptions nationally come from emergency rooms.

"There's a message to those going into those emergency rooms: We're not giving the stuff to you willy-nilly anymore," Mr. Kasich said. "We're not going to allow you to get a prescription and go out and give it some relative or give it to some kid, or give it to anybody. … Not only were the emergency rooms excited about cooperating with these protocols, but then the urgent care centers came in and said, ‘Can we help, too?'?"

Dr. Ted Wymyslo, director of the Ohio Department of Health, said the voluntary guidelines don't have the force of law, so an emergency room or urgent care center that strays would not face penalties.

"You don't want to be the [emergency department] or urgent care in your community that does not follow this, because you will get everyone who wants to divert drugs or wants to abuse drugs coming to your center, and that's largely not what any of these centers wants to be about," he said.

The state began distributing the new protocols on Monday.

"Handling this challenge with statewide agreement allows hospitals to present a united front, encouraging those in chronic pain to work closely with their primary care physicians while discouraging dangerous, drug-seeking behavior that is part of the addiction epidemic Ohio is working to break," said Mike Abrams, president and CEO of the Ohio Hospital Association.

The guidelines attempt to prevent repeat emergency room prescriptions for the same injuries, longer-term prescriptions for opiods like OxyContin and methadone, and routine replacement of reportedly lost or destroyed prescriptions. Emergency rooms would reserve the right to perform urine or other methods of drug screening on patients and request medical and prescription records from other hospitals.

"By and large, the emergency department physicians won't be prescribing more than a three-day supply of opioids and other controlled substances, because they want to reconnect patients with their own personal physicians or some specialist," Dr. Wymyslo said. "They are buying them the time to get to the ultimate care that they're seeking."

Contact Jim Provance at: jprovance@theblade.com or 614-221-0496.