Provisional Iowa Public Health data notes 301 opioid overdose and related deaths in 2017 – an increase from 266 such deaths in 2016 and 222 in 2015. On February 26, the Iowa House unanimously passed HF 2377, this session’s first major legislation addressing the opioid crisis. The bill focuses on the abuse of prescription opioids, while seeking to improve the response to some drug overdoses. The bill does not address the need to expand drug abuse treatment.
Enhancing Iowa’s prescription monitoring program (PMP) is a central feature of the legislation. This program collects information from pharmacies on dispensing controlled substances, including opioids. The PMP can be used to determine whether prescribing or dispensing might contribute to a patient’s abuse of or dependence on addictive drugs or diversion of those drugs to illicit use. The PMP’s current utility is limited, however, by a lack of funding, inconsistent utilization, and delays in posting information.
HF 2377 increases funding for the PMP by authorizing the Board of Pharmacy to impose a surtax on businesses dispensing or distributing controlled substances. This funding will enhance the PMP’s capacity and usability and enable it to advise physicians and pharmacists of suspected overuse of opioids.
The legislation improves the program’s utility in several ways. The bill requires all prescribing practitioners to register for the program and submit all prescriptions electronically by January 1, 2020. All pharmacies and prescribing practitioners who dispense a controlled substance must report their activity within 24 hours.The Board of Pharmacy must annually issue a prescribing practitioner activity report of PMP activity and establish criteria for identifying patients who may be potentially misusing or abusing prescription-controlled substances and share the board’s concern with pharmacists and prescribing practitioners involved in those patients’ care.
The legislation requires licensing boards to establish penalties for practitioners who prescribe in dosage amounts exceeding what would be prescribed by a reasonably prudent prescribing practitioner. The bill provides additional sanctioning authority for the Board of Pharmacy for violations of Iowa’s Controlled Substance Act by those dispensing controlled substances.
HF 2377 encourages prompter responses to drug overdose situations by creating a “Good Samaritan” protection. This provision ensures that a person seeking medical treatment for someone experiencing a drug-related overdose is not arrested or prosecuted for controlled substance-related violations based on information collected or derived from the person’s actions in seeking medical assistance. To qualify for immunity, the “Good Samaritan” must have acted in good faith,been the first to do so, left a name and contact information, remained on the scene until assistance arrives, and cooperated with authorities. The assistance must not have been provided during the execution of an arrest or search warrant.
The legislation now goes to the Iowa Senate for its consideration. The Senate Human Resources Committee has already approved less comprehensive anti-opioid legislation, SF 2198.