H.F. 2140 Section 1. NEW SECTION . 124.559 Provision of information —— 1 prescribing of controlled substances for acute or chronic pain. 2 1. Prior to issuing an initial prescription for a schedule 3 II controlled substance or any other prescription opioid in a 4 course of treatment for acute or chronic pain, and again prior 5 to issuing the third prescription in the course of treatment, 6 a prescribing practitioner shall discuss with the patient, 7 or the patient’s parent or guardian if the patient is under 8 eighteen years of age and is not an emancipated minor, the 9 risks associated with the substance being prescribed, including 10 but not limited to: 11 a. The risks of addiction and overdose associated with 12 opioid drugs and the dangers of taking opioid drugs with 13 alcohol, benzodiazepines, and other central nervous system 14 depressants. 15 b. The reasons why the prescription is necessary. 16 c. Alternative treatments that may be available. 17 d. The risks associated with the use of the substance 18 being prescribed, specifically that opioids are highly 19 addictive, even when taken as prescribed, that there is a 20 risk of developing a physical or psychological dependence on 21 the substance and that the risks of taking more opioids than 22 prescribed, or mixing sedatives, benzodiazepines or alcohol 23 with opioids, can result in fatal respiratory depression. 24 e. The dangers and risks of use of the substance to persons 25 other than the patient using the substance. The prescribing 26 practitioner shall advise the patient to keep the substance in 27 a locked container. 28 2. The prescribing practitioner shall include a note 29 in the patient’s medical record that the patient or the 30 patient’s parent or guardian, as applicable, has discussed 31 with the practitioner the risks of developing a physical or 32 psychological dependence on the prescribed substance and 33 alternative treatments that may be available. 34 3. This section shall not apply to a prescription for the 35 -1- LSB 5835YH (3) 88 ss/rh 1/ 3

H.F. 2140 substances specified for a patient who is currently in active 1 treatment for cancer or receiving hospice or palliative care 2 through a hospice program as defined in section 135J.1, for the 3 resident of a long-term care facility, or to any substances 4 that are being prescribed for use in the treatment of substance 5 use disorder or opioid dependence. 6 4. As used in this section: 7 a. “Long-term care facility” means the same as defined in 8 section 231.4. 9 b. “Prescribing practitioner” means the same as defined in 10 section 124.550. 11 Sec. 2. CODE EDITOR DIRECTIVE. The Code editor shall 12 designate section 124.559, as enacted in this Act, as a new 13 subchapter within chapter 124. 14 EXPLANATION 15 The inclusion of this explanation does not constitute agreement with 16 the explanation’s substance by the members of the general assembly. 17 This bill relates to the information to be provided by a 18 prescribing practitioner to a patient prior to the prescribing 19 of a controlled substance for acute or chronic pain. The bill 20 provides that prior to issuing an initial prescription of a 21 schedule II controlled substance or any other prescription 22 opioid in a course of treatment for acute or chronic pain, and 23 again prior to issuing the third prescription in the course of 24 treatment, a prescribing practitioner shall discuss with the 25 patient, or the patient’s parent or guardian if the patient 26 is under 18 years of age and is not an emancipated minor, the 27 risks associated with the substance being prescribed. The 28 information to be discussed includes but is not limited to: 29 the risks of addiction and overdose associated with opioid 30 drugs and the dangers of taking opioid drugs with alcohol, 31 benzodiazepines, and other central nervous system depressants; 32 the reasons why the prescription is necessary; alternative 33 treatments that may be available; the risks associated with 34 the use of the substance being prescribed; and the dangers 35 -2- LSB 5835YH (3) 88 ss/rh 2/ 3

H.F. 2140 and risks of use of the substance by persons other than the 1 patient. The prescribing practitioner shall include a note 2 in the patient’s medical record that the patient or the 3 patient’s parent or guardian, as applicable, has discussed 4 with the practitioner the risks of developing a physical or 5 psychological dependence on the prescribed substance and 6 alternative treatments that may be available. The bill does 7 not apply to a prescription for the substances specified in 8 the bill for a patient who is currently in active treatment 9 for cancer or receiving hospice or palliative care through a 10 hospice program, for the resident of a long-term care facility, 11 or to any substances that are being prescribed for use in the 12 treatment of substance use disorder or opioid dependence. 13 -3- LSB 5835YH (3) 88 ss/rh 3/ 3