• research on customers so distributors better understand when an order might be deemed suspicious;
• holding off shipment of suspicious orders until they are investigated further.
Distributors that fail to abide by the new rules risk losing their state licenses, Kasich said.
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The Board of Pharmacy rules say that suspicious orders may be any orders of more than 5,000 unit doses, any that appear to be statistical outliers based on previous purchases, uncommon methods of payment, or an unusual frequency of orders.
The OARRS system, created in 2006, is a powerful data tracking tool that has been beefed up in recent years to help Ohio crack down on “doctor shopping,” close pill mills and reduce prescription painkillers being misused.
Related: Drug crisis in Ohio: What solutions are making a difference?
Prescribers, pharmacists and distributors are required to report to and check OARRS. In October 2015, the system averaged 65,000 queries a day and by December 2017 that average climbed to 444,000 queries per day, according to Ohio Board of Pharmacy Executive Director Steven Schierholt.
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Ohio has taken steps to combat the opioid crisis, including expanding Ohio Medicaid under Obamacare, which freed up money for drug addiction treatment services; requiring pharmacy technicians to register with the Board of Pharmacy; limit opiate prescriptions to a 90-day supply; and issue prescribing guidelines for chronic pain management clinics, emergency rooms, and acute care facilities.
The state issued new mandatory restrictions on opiate prescriptions for acute pain in August 2017.
Related: Ohio sets new limits on painkiller prescriptions
Kasich said Ohio is at a six-year low in accidental fatal drug overdoses attributed to prescription opiates.
The Ohio Department of Health data show accidental fatal drug overdoses climbed from 3,050 in 2015 to 4,050 in 2016. But the number of fatalities attributed to prescription overdoses fell to to 564 in 2016 — a 15 percent drop over 2015 and the lowest number since 2009.