State Group Resumes Work On Opiate Guidelines

The Prescribing Work Group of the Governor’s Cabinet Opiate Action Team (GCOAT) met April 22 for the first time since August 2012.

After developing prescribing guidelines for opiates in emergency departments (ED) and other acute care settings that were endorsed by the OOA, the Ohio Hospital Association and other professional groups representing prescribers who serve in EDs, the group turned its attention to the development of best practice guidelines for prescribing opiates in physician offices and other outpatient settings.

The current outpatient recommendations have a “trigger” for any chronic, non-terminal pain patient who has received 80 mg or more of morphine equivalent daily dose (MED) over the past 90 days, as determined through the OARRS database. This trigger point requires the physician to ensure appropriate documentation is in place and the patient is reassessed for possible referral to a pain clinic, among other things.

GCOAT has backed away from issuing rules, which have the force of law, at the collective insistence of stakeholders. Instead, the administration is working with appropriate licensing boards on practice guidelines. The administration hopes to have uniform guidelines in place by July 1 and has given stakeholders a short timeframe for comments before the guidelines are approved by the licensing boards.

By agreeing to issue guidelines rather than rules, the administration is also challenging the provider community to make a positive change in opiate prescription overuse and abuse within a year.

The GCOAT Prescribing Task Force, which includes four osteopathic physicians, will continue to work during this time to develop educational tools for physicians and other providers, matrixes to measure success, and other improvements to the OARRS system.

According to recent statistics, Ohio now leads the nation in the number of checks made to any OARRS-like database system. DOs serving on the GCOAT Prescribing Work Group include Cleanne Cass, DO; Michael V. Bourn, DO; R. Aaron Adams, DO; and Maury L. Witkoff, DO. Dr. Cass is OOA’s designated representative. If you have questions, send an e-mail to OOA Executive Director Jon F. Wills at

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