Ohio Emergency and Acute Care Facility
Opioids and Other Controlled Substances (OOCS) Prescribing Guidelines

The Governor’s Cabinet Opiate Action Team (GCOAT) was established in the fall of 2011 to address the continuing epidemic of misuse and abuse and overdose from prescription opioids.  The GCOAT consists of five working groups: (1) Treatment--includes Medication Assisted Treatment; (2) Professional Education; (3) Public Education; (4) Enforcement; and (5) Recovery Supports.  

Under the leadership of Dept. of Health Director Dr. Ted Wymyslo and Department of Aging Director Bonnie Kantor-Burman, the Opioids and other Controlled Substances guidelines were developed through a multidisciplinary effort involving many state medical and health care associations, emergency departments and acute care facilities, state agencies and boards, as well as individual physicians, nurses and other clinicians.

Guidelines

Prescribing Guidelines

Patient Handout

Frequently Asked Questions

Background Document

Background Document

Appendix A - Screening Tools (SBIRT)

Appendix B - Sample Pain Agreements

Appendix C - Sample Discharge/Follow-Up Care Instructions

Promotional Materials

The Professional Education Workgroup of the Governor's Cabinet Opiate Action Team prepared supporting materials to help promote the adoption of the ED Guidelines.  This document includes:

• Introductory Email/Letter for Professional Organizations
• Facebook Posts
• Website Content
• Customizable Press Release template
• Newsletter Article

Click here to download the promotional materials.

Pocket Cards

The Ohio Department of Health printed a limited number of pocket-size cards of the ED Guidelines for emergency and acute care facility prescribers.  If you are interested in receiving a card or would like to distribute copies, please email HealthyO@odh.ohio.gov.

Examples of the OOCS Prescribing Guidelines in Practice

Why Emergency Departments/Acute Care Facilities?

• Nationally, opioid prescribing for pain-related ED visits increased from 23 percent in 1993 to 37 percent in 2005.  (Source: JAMA, Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US EDs)

• Emergency Department/Acute Care Facilities treatment of pain is frequently indicated without the benefit of an established doctor-patient relationship and often is conducted in an environment of limited resources.

• In Ohio, 16 percent of fatal overdose victims in 2008 had a history of doctor shopping (filled prescriptions from at least five different prescribers per year). (Source: OAARS & ODH Vital Statistics)

• Closure of “pill mills” may result in increased drug seeking behavior (e.g. doctor shopping) at EDs.

Ohio Process

• A subgroup of the Professional Education Workgroup was formed to develop the guidelines.

• Washington State prescription guidelines were used as a starting point in addition to feedback from Ohio emergency departments.

• The guidelines are endorsed by the Ohio Chapter of the American College of Emergency Physicians, Ohio Association of Health Plans, Ohio Association of Physician Assistants, Ohio Bureau of Workers’ Compensation, Ohio Hospital Association, Ohio Osteopathic Association, Ohio Pharmacists Association, Ohio State Medical Association, Ohio Bureau of Workers’ Compensation, Urgent Care College of Physicians and facilitated by the Ohio Departments of Health and Aging.

• Intended as guidelines not Standards of Care. Clinical judgment is still the determining factor in prescribing practices.

Webinar

On April 16, 2013, the Ohio Department of Health and the Ohio Injury Prevention Partnership hosted a webinar to review the lessons learned from the implementation of prescribing guidelines in facilities around Ohio.  The webinar was archived and can be viewed below. 

Slides from the presentation can be accessed here.

Prescription Drug Overdose in Ohio

For more information on prescription drug overdose in Ohio, please visit the ODH Drug Overdose web page: http://www.healthyohioprogram.org/vipp/drug/dpoison.aspx

Last Reviewed 4/16/13