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from the State Medical Board of Ohio

Board Seeks Comments Regarding Proposed Acute Pain Rules

The Medical Board is accepting comments on proposed amendments to two existing rules and a proposed new rule that will limit initial opioid analgesic prescriptions for acute pain to 5 days for minors and 7 days for adults. The rules also include a 30MED average daily dose limit. 

(1) Rule 4731-11-01 Definitions Amended by adding definitions for acute pain, morphine equivalent dose, minor, extended-release or long-acting opioid analgesic, opioid analgesic, palliative care and terminal condition.

(2) Rule 4731-11-02 General Provisions Amended by adding a requirement that physicians and physician assistants must follow Rules 4729-5-30 and 4729-5-13, Ohio Administrative Code. This will include the requirement that prescriptions for controlled substances will need to include the diagnosis.

(3) New Rule 4731-11-13 Prescribing of opioid analgesics for acute pain

  • Limits prescriptions for opioid analgesics to treat acute pain to no more than a seven-day supply for adults and a five-day supply for minors. If the physician determines that the pain is expected to persist for longer than seven days, the physician may prescribe for a longer period, but the reason for exceeding the limits and for prescribing an opioid analgesic must be documented in the patient’s medical record.

  • Requires that the patient and the parent or guardian of a minor patient is advised of the benefits and risks of the opioid analgesic, including the potential for addiction.

  • Clarifies that the rule does not apply to the treatment of patients receiving hospice or palliative care, cancer and terminal illness, or medication assisted treatment for addiction.

​*These proposed rules do not apply to your chronic (long-term) pain patients.


Send comments to by Friday, April 28, 2017.

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