For Medical Professionals

The Trumbull County Mental Health & Recovery Board is mobilizing a broad spectrum of community stakeholders – spanning education, law enforcement, health and human services agencies, hospitals, parents, and others – to reduce the devastating impacts of drug abuse and addiction in our community. As a physician, dentist or pharmacist, we’re asking you to play an important role in that effort.

In particular, we ask you to do three important things:

Use the Ohio Automated Rx Reporting System (OARRS) system to check each of your patients and customers before you write or fill a prescription.
OARRS is a tool that allows prescribers, pharmacists and certain law enforcement officials to quickly identify drug seeking behaviors and thus help keep potentially dangerous medications out of the hands of addicts and abusers. An OARRS Prescription History Report also helps assure that your patient is getting the appropriate drug therapy and is taking his or her medication as prescribed. To access OARRS click here.

Be vigilant about watching for aberrant medication-related behaviors in your patients and customers.

In particular, these signs have been identified as red flags:

Utilize the safe prescribing guidelines provided by the Governor’s Cabinet Opiate Action Team.

In its ongoing efforts to combat drug abuse and save lives, the Governor’s Cabinet Opiate Action Team established in 2011 has developed prescribing guidelines for the outpatient management of acute pain. The acute guidelines follow previous prescribing guidelines for emergency departments and the management of chronic pain. All three guidelines were developed in conjunction with clinical professional associations, healthcare providers, state licensing boards and state agencies. The prescribing guidelines are designed to prevent “doctor shopping” for prescription opioids, to urge prescribers to first consider non-opioid therapies and pain medications, to reduce leftover opioids that can be diverted for abuse, and to encourage prescribers to check OARRS before prescribing opioids to see what other controlled medications a patient might already be taking. To view the prescribing guidelines click here .

If you suspect your patient is abusing drugs, talk to them about their usage. If necessary, refer the patient to an appropriate treatment facility. Click here for a list of local treatment providers.

When treating a patient with controlled prescriptions, the earlier you can identify a problem the better. Always keep an eye and ear out for changes in behavior, failure to maintain eye contact, slurred speech, ready excuses for inappropriate or problem behaviors, and/or a nervous or jittery manner.

Also, learn to identify medication-seeking behavior. Patients who compulsively use medication, continue to use medication despite harm, complain they need more medication, horde medication, or request specific medications should raise your concern, says psychiatrist and attorney H. Westley Clark, who serves as director of the Center for Substance Abuse Treatment under the Substance Abuse and Mental Health Services Administration in Rockville, Md.

Also, learn to differentiate between "yellow flag" and "red flag" behavior, says Cleveland-based internal and addiction-medicine physician Theodore Parran. Yellow flag behavior indicates a patient may be abusing prescriptions and you should proceed with caution when treating him. Red flag behavior indicates a patient's health or safety is threatened, and you should refer the person for an addiction assessment and titrate the person off of the medication.

When titrating a patient off of their medication, utilize the safe titration protocols provided by the Centers for Disease Control: Pocket Guide: Tapering Opioids for Chronic Pain

For more resources visit Take Charge Ohio