Here's how Ohio is working to reduce opioid prescriptions

Ohio has the second highest rate of drug overdose-related deaths in the country. Alternatives to traditional medical treatments may be preventing the problem from worsening.

[dropcap txtcolor="#234a83" style="dropcap1"]P[/dropcap]atients who suffer from pain might see alternative forms of relief besides opioid related medication, according to new standards from the Joint Commission.The Ohio health organizations, many of which are certified by the Joint Commission (which certifies thousands of healthcare organizations throughout the country), released a new pain assessment and management standards on Jan. 1 in response to increasing reliance on opioid medication used to treat pain in hospital patients.Ohio has the second highest rate of drug overdose-related deaths after West Virginia, causing several Ohio health organizations to take interest in pushing the Joint Commission to change their policies for pain treatment.[AdSense-A]These new guidelines encourage hospitals to provide patients with information about non-pharmacological pain treatment methods.In January 2016 and May 2017, the Governor’s Cabinet Opiate Action Team released guidelines for treating pain without opiods. One of the most vocal opioid-related task forces has been the Ohio Chiropractic Association Opioid Action Team. They emphasize offering non-prescription alternatives, like chiropractic care, for pain treatment. Dr. Patrick Ensminger, the President of the Ohio State Chiropractic Association Opioid Task Force, indicated that the Joint Commission's original decision in 2001 to make pain a vital sign was one of the biggest contributors to over-prescription of opioid medication. He pointed out that not only is it difficult to measure pain objectively, but hospitals usually rely on prescription drugs as a primary way to treat pain.“There was no accidental part of this,” said Ensminger. “This was too much miscommunication, misinformation and too much trust being given to people that resulted in recommendations that should have never occurred.” The Joint Commission no longer endorses pain as a vital sign on their official website, and also notes that they do not require hospitals to use opioid drugs to treat patients with pain.The OSCA and the American College of Physicians have also released materials regarding proper pain treatment and opioid use for treating pain. Additionally, the Ohio Department of Medicaid has included acupuncture treatment in Medicaid plans for certain diagnoses. Dr. Mickey Frame, the former president of the OSCA, pointed out that roughly 75 percent of the population that gets started with opiods are being treated for lower back pain or neck pain, which can both be treated with alternative care.  However he added that it is uncommon for hospitals, or other health care physicians, to refer patients to chiropractors or alternative care physicians. “To give an example, when my daughter was 13, she broke her nose,” Frame said. “I took her to the emergency room, and the first thing the ER doctor wanted to do was prescribe oxycodone.”Ensminger said that many chiropractic care providers still struggle to connect themselves to hospitals and other large medical institutions. However, chiropractors have continued conversations with both hospitals and lawmakers about the importance of alternative care. “I’ve seen opportunities to work with lawmakers in the future, and hopefully break out of Ohio and into the national level, because most of the dialogue is about the addicts, but we want to have more conversation about preventing new addicts,” Ensminger said. Hospitals operate in a bureaucratic maner and are slow to change their ways, according to Ensminger. There has been communication with hospitals and members who work to educate patients, he added.Ohio’s chiropractors continue to advocate for alternatives to traditional opioid medications as a way to focus on preventing further addiction going forward, rather than trying to treat addiction issues retroactively. “Less people are talking about how do we prevent people from getting addicted to opioids, which are how we get people who are addicted to heroin in the first place,” Frame said. “We’re looking at in the beginning rather than the end game, because a lot of time, the end game is too late.”