130th Ohio General Assembly
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H. B. No. 332  As Introduced
As Introduced

130th General Assembly
Regular Session
2013-2014
H. B. No. 332


Representatives Wachtmann, Antonio 

Cosponsors: Representatives Sprague, Sheehy 



A BILL
To enact sections 3719.62, 4715.303, 4723.283, 4725.191, 4730.252, and 4731.229 of the Revised Code to establish standards and procedures for opioid treatment of chronic, intractable pain resulting from noncancer conditions and to require that professional disciplinary action be taken for failing to comply with those standards and procedures.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1.  That sections 3719.62, 4715.303, 4723.283, 4725.191, 4730.252, and 4731.229 of the Revised Code be enacted to read as follows:
Sec. 3719.62.  (A) For use by licensed health professionals authorized to prescribe drugs, the following standards and procedures are hereby established as the approach to be followed when undertaking opioid treatment of patients less than fifty years of age with chronic, intractable pain resulting from conditions other than cancer:
(1) Prior to considering any prescription of opioids for chronic, intractable pain, such as low back pain, a referral to a pain medicine specialist shall be made to evaluate the patient for treatment options other than opioid treatment. Opioid treatment on a long-term basis shall be considered only after exhausting other treatment options.
(2) If opioid treatment for chronic, intractable pain resulting from a condition other than cancer is deemed appropriate after evaluations from one or more pain medicine specialists have been obtained, the prescriber may initiate and maintain the treatment. Opioid treatment shall be monitored by doing all of the following:
(a) Documenting the diagnosis for which the treatment is undertaken;
(b) Documenting the evaluation performed for the diagnosis;
(c) Obtaining the patient's informed consent, including a discussion of alternate treatments, the risks and benefits of the opioid treatment, and the conditions to be met by the patient for continuation of the treatment, including an opioid agreement to be signed by the patient;
(d) Assessing the patient's pain level and functional level before initiating the treatment;
(e) Evaluating the patient's risk of addiction before initiating the treatment;
(f) Evaluating the patient's function and pain status routinely during treatment;
(g) Documenting each treatment plan used and the rationale for any continuation of or change in the treatment regimen, while also evaluating the patient during each treatment encounter to determine the patient's compliance with the treatment plan and the patient's health status, including any adverse effects of the treatment;
(h) Identifying any misuse of opioids or other drugs by regularly obtaining information about the patient from the drug database established and maintained by the state board of pharmacy pursuant to section 4729.75 of the Revised Code and conducting random drug testing of the patient during treatment.
(3) Because the mixing of benzodiazepines and opioids has synergistic effects on respiratory depression, the prescriber shall consider such treatment only in rare situations.
(4) The prescriber shall warn the patient of the risks of combining opioids with other central nervous system depressants, including alcohol, benzodiazepines, and other sedatives.
(5) Any patient request for higher opioid dosing shall be considered a reason for reevaluating the patient and making another referral to a pain medicine specialist, a referral to an addiction or substance abuse specialist, or referrals to both.
(6) If at any other time there is reason to believe that the patient is suffering from addiction or drug abuse, the prescriber shall consult with an addiction or substance abuse specialist.
(B) The standards and procedures established under this section are in addition to the provisions of section 4731.052 of the Revised Code and the rules adopted by the state medical board under that section establishing standards and procedures to be followed by physicians in the diagnosis and treatment of chronic pain. In the event that there is a conflict between the provisions of this section and the board's standards and procedures, the provisions of this section shall prevail.
Sec. 4715.303.  The state dental board shall take action under section 4715.30 of the Revised Code against an individual for failing to comply with the standards and procedures established by section 3719.62 of the Revised Code as the approach to be followed when undertaking opioid treatment of patients less than fifty years of age with chronic, intractable pain resulting from conditions other than cancer.
Sec. 4723.283.  The board of nursing shall take action under section 4723.28 of the Revised Code against an individual for failing to comply with the standards and procedures established by section 3719.62 of the Revised Code as the approach to be followed when undertaking opioid treatment of patients less than fifty years of age with chronic, intractable pain resulting from conditions other than cancer.
Sec. 4725.191.  The state board of optometry shall take action under section 4725.19 of the Revised Code against an individual for failing to comply with the standards and procedures established by section 3719.62 of the Revised Code as the approach to be followed when undertaking opioid treatment of patients less than fifty years of age with chronic, intractable pain resulting from conditions other than cancer.
Sec. 4730.252.  The state medical board shall take action under section 4730.25 of the Revised Code against an individual for failing to comply with the standards and procedures established by section 3719.62 of the Revised Code as the approach to be followed when undertaking opioid treatment of patients less than fifty years of age with chronic, intractable pain resulting from conditions other than cancer.
Sec. 4731.229.  The state medical board shall take action under section 4731.22 of the Revised Code against an individual for failing to comply with the standards and procedures established by section 3719.62 of the Revised Code as the approach to be followed when undertaking opioid treatment of patients less than fifty years of age with chronic, intractable pain resulting from conditions other than cancer.
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