H.B. 167: Prescription Reforms to help quell Opioid Addiction
By Mark Rogers
H. B. 167 was introduced by Representative Jay Edwards (R-Nelsonville)} is one more targeted effort to deal with Ohio’s drug abuse crisis. In the case of H. B. 167, the legislation seeks several reforms to existing practices related to how certain drugs are prescribed. The legislative summary is here.
Key areas of the bill include:
Revises rules for prescribing opioid analgesics.
Sets a three day limit on the time a primary care physician or general dentist can prescribe opioid analgesics and limits the daily dosage to a Morphine Equivalent Dose to 50 milligrams.
Specifies conditions under which primary care physician and general dentists can exceed the three day limit to seven days.
Authorizes the State Medical Board to develop rules for prescriptions written by doctors and dentists who specialize outside primary care or general dentistry.
Among the conditions set by H. B. 167 that would allow exceptions to the three day limit are requirements for doctors and dentists to receive a set amount of training on opioids and opioid addiction. It also requires annual continuing education, as well as the ability to treat or refer patients for treatment of opioid dependence or addiction. The time limits do not apply in certain situations such as for patients with cancer or in hospice care.
Representative Edwards described his legislation to 3rd Rail Politics, “House Bill 167 aims to stop more Ohioans from becoming addicted while also increasing access to treatment for people who are already addicted.”
Revises the law governing physician treatment of chronic pain with controlled substances. Requires physicians to satisfy certain conditions, prohibiting treatment with a drug exceeding 50 MED. Requires a review of federal guidelines for tapering a patient off a drug.
H. B. 167 revises state law to increase the conditions under which opioid analgesics can be proscribed for chronic pain. The new provisions include:
“ (1) The physician must complete at least eight hours of training approved by the Medical Board relating to addiction;
(2) The physician must utilize an electronic medical records system that provides direct access to reports of patient information from OARRS;
(3) The physician must annually complete at least two hours of continuing education approved by the Medical Board relating to prescribing controlled substances.”
∙ “Requires a physician who provides medication-assisted treatment for addiction in accordance with federal law to offer each patient treatment with naltrexone.”
∙ “Requires the Department of Mental Health and Addiction Services to develop online courses that provide counseling and other services required by federal law for patients receiving office-based medication-assisted treatment.”
Requires the dispensing or furnishing of naltrexone to be reported to the Ohio Automated Rx Reporting System (OARRS) and makes other changes to the law governing OARRS.
Antonio Ciaccia, Director of Marketing and Government Affairs for the Ohio Pharmacists Association, finds much to like about H. B. 167. Specifically he see the provisions relating to naltrexone as valuable. “Allowing pharmacists to provide small numbers of pills to people who need only need a couple of days before they can receive the longer-acting injections will ensure fewer addicts start reusing illegal drugs and that is key to keeping recovering addicts from sliding back into using.”