Ohio sets new guidelines for short-term pain prescribing


COLUMBUS, Ohio (AP) — People with short-term pain from injuries or surgery should be given alternatives to prescription painkillers whenever possible and be provided only the minimum amounts if absolutely needed, according to guidelines announced Tuesday by Gov. John Kasich’s office.

Alternatives to the class of painkillers known as opioids could include ice, heat, wraps, stretching, massage therapy, acupuncture, seeing a chiropractor or physical therapy, along with medicines that don’t have addictive qualities, such as ibuprofen, said Dr. Mary DiOrio, medical director for the state Department of Health.

“In most cases, opioids should be used as adjuncts to additional therapies, rather than used alone,” DiOrio said.

The prescribing guidelines mark the third such effort to reduce the use of painkillers to help address Ohio’s drug epidemic. The overprescribing of painkillers helped open the door to the current heroin problem, which hit record levels of fatal overdoses in 2014.

Accidental drug overdoses have killed more Ohioans than car crashes since 2007.

Ohio previously set guidelines to reduce the prescribing of painkillers in emergency rooms and for closer monitoring of prescriptions for people suffering chronic pain, such as cancer patients.

The guidelines will help restore balance to a treatment system under which doctors were once afraid to prescribe painkillers for fear of addictions, said Dr. Michael Kelley, senior medical director for ambulatory services for OhioHealth.

“While we should not go back to the days when physicians were afraid to treat pain, we must swing the pendulum back to the center and curtail the current epidemic of medication use,” he said.

State medical associations and licensing boards signed off on the voluntary guidelines, which stop short of requiring doctors to prescribe set numbers of drugs.

Health professionals wanted to avoid a one-size-fits-all approach that such mandates might create, said Jon Wills, executive director of the OhioOsteopathic Association.

A former high school athlete said the availability of painkillers helped turn him into a heroin addict who suffered a near-fatal overdose three years ago.

Dakota Brooks, 23, was prescribed Vicodin after a lacrosse injury at his high school in Hilliard in suburban Columbus. Accustomed to the pills, he was given more by friends whose parents had leftovers in their medicine cabinets. From there, he graduated to heroin, said Brooks, who is in recovery and now counsels students about the dangers of painkiller addiction.

“It’s like a modern-day slavery, waking up every day to get your fix,” he said. “And if you don’t, it’s worse than ever.”

Last week, Ohio lawmakers backed by Attorney General Mike DeWine backed a related federal effort to curb the prescribing of painkillers.

The proposals by the Centers for Disease Control and Prevention call for considering non-addictive painkiller alternatives first, shortening prescription times for acute pain and lowering doses for chronic pain.

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