Ohio doctors must now offer naloxone to some pain patients

A rule that recently went into effect in Ohio requires physicians who prescribe comparatively high doses of opioids for the treatment of long-term pain to also offer patients a prescription for naloxone.

A rule that recently went into effect in Ohio requires physicians who prescribe comparatively high doses of opioids for the treatment of long-term pain to also offer patients a prescription for naloxone. Mark Hurst, MD, of the Ohio Department of Mental Health and Addiction Services, says: "We want people to get good treatment, but we want it to be safe. The point of all this is to enhance the dialogue between patient and prescriber." The new rules vary depending on the dosage prescribed. At a daily morphine milligram equivalent dose of 80, prescribers are required to look for signs of prescription misuse, consult with a specialist, obtain a written pain-management agreement with the patient, and offer a prescription for naloxone. Although the State Medical Board of Ohio did not require that the naloxone prescription be written—as sought by many advocates—physicians must document that they offered it. Kiran Rajneesh, MD, a neurologist and pain physician at Ohio State University's Wexner Medical Center, says he is concerned that for some patients on high doses, the new rules might require them to see more than one doctor, such as a specialist or certified pain-medicine physician. The rules do not apply to patients receiving medication for terminal conditions or those being closely monitored in a hospital.