LIMA — It can start with what most people in the medical field define as standard procedure. A doctor prescribes opioids to a patient for a medical need. But for some of these patients, the drug that’s meant to help them quickly turns into an addiction that upends their entire lives.
In an effort to combat this problem, a variety of initiatives have been put forth to limit the amount of opioids prescribed in Ohio.
Established in 2006, the Ohio Automated Rx Reporting System is a statewide database that collects information on all prescriptions for controlled substances that are dispensed by pharmacies and furnished by licensed prescribers in Ohio. OARRS data is available to prescribers when they treat patients, pharmacists when presented with prescriptions and law enforcement officials during active investigations.
In 2015, Ohio Gov. John Kasich announced a $1.5 million a year investment to make Ohio the first state in the U.S. to integrate its prescription monitoring program directly into electronic medical records and pharmacy dispensing systems across the state. This allows prescribers and pharmacists to automatically check a patient’s controlled substance use within the same system they use every day.
“If a physician is prescribing narcotics for longer than seven days, then they’re required to run a report and document in the medical record that they checked their OARRS report,” said Brian Latham, director of pharmacy at St. Rita’s Medical Center.
“But there are certain situations they don’t have to run it, like if it’s a patient they’re retaining after surgery, or if it’s a hospice patient.”
A recent OARRS report reveals that in 2015, the total doses of opioids dispensed in Ohio decreased to 701 million from a high of 793 million in 2012, a drop of 11.6 percent.
Additionally, the number of opioid prescriptions written to Ohio patients decreased by 1.4 million during the same time period. Regionally, the number of opioid doses dispensed per patient in Allen, Auglaize, Hardin and Putnam counties have declined each year since 2013. OARRS data also showed a 71 percent decrease in the amount of people engaging in “doctor shopping” since 2010.
But for Dr. Vikas Pilly, a pain management specialist at Lima Memorial Health System, a lot more can be done to limit the number of opioids prescribed.
“Some physicians don’t even look at the OARRS report, and they don’t make sure there’s significant, objective findings to justify prescribing pain medications,” Pilly said. “It varies from one physician to another, so I think there should be a national algorithm that every doctor needs to follow, and if they don’t, there should be some penalties.”
Instead of having a system like OARRS that only covers one state, Pilly wants to create a national database where every patient seeing a pain management specialist is required to register.
“OARRS is good for the state of Ohio, but what if they come from Florida? We have no idea what their history is,” he said. “But if we had a national database, we could see if a patient recently registered with another pain clinic and make a determination of whether or not to write a prescription.”
Pilly is also in talks with state Rep. Bob Cupp, R-Lima, to develop a law that would allow pain management doctors to report potential drug-seeking patients to the police.
“That way, if patients who are looking just for pain medications know we can report them, then less of them will show up at our clinics,” he said.
Mark Recker, director of pharmacy at Lima Memorial, said exploring alternative methods to treating pain could also cut down on the amount of opioids prescribed, which may lead to less people addicted.
“There has been a push to use things like Ibuprofen and Tylenol, which are surprisingly very good for pain relief when compared to opioids,” Recker said. “I also think physical therapy is becoming more and more of a treatment option for chronic pain rather than opiates.”
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