Opioid Prescription

Effective today, Aug. 31, 2017, the Ohio Boards of Nursing, Medicine, Dentistry and Pharmacy respectively has new rules on prescription opioids for the treatment of acute pain.

The Nursing Board urges APRN prescribers and all licensees to review new Rule 4723-9-10 OAC. The rule specifies standards for APRN prescribing and sets parameters for prescribing opioids for treatment of acute pain.These rules DO NOT apply for the use of Opioids for chronic pain. Click HERE for link to ORC Rule 4723-9-10.

The rule DOES NOT apply to: Inpatient care, hospice care, palliative care, terminal condition, cancer or cancer condition, history of cancer or medication-assisted treatment for addiction.

Rule provisions:

  1. Consider non-opioid treatment options.
  2. Extended release or long-acting opioid analgesics shall not be prescribed for the treatment of acute pain.
  3. No more than seven-day opioids for adults 18 and over.
  4. No more than five-day supply for minors under 18.
  5. May exceed the five or seven-day limit ONLY if a specific reason in documented in the medical record.
  6. Use the total morphine equivalent dose (MED) when calculating daily dose. APRNs MAY NOT exceed 30 MED. a. MED is a tool to equate the many different opioids into one standard value. This standard value is based on Morphine and its potency.

NOTE: The Ohio Revised Code 4723-9-10 for APRNs does NOT include any exceptions for exceeding 30 MED. If the plan of care for your patient exceeds 30 MED, the physician must write the prescriptions or the plan of care be revised to equal less than 30 MED.

Click here for Oral Morphine Milligram Equivalent Conversion table and calculator.

For more, stay tuned on our blog.