Senate File 2208 - Introduced SENATE FILE 2208 BY WEINER , CELSI , QUIRMBACH , WINCKLER , TRONE GARRIOTT , PETERSEN , and DONAHUE A BILL FOR An Act relating to the standards of practice relating to the 1 prescribing of certain pain medications. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5806XS (4) 90 pf/ko

S.F. 2208 Section 1. BOARD OF MEDICINE —— STANDARDS OF PRACTICE FOR 1 PRESCRIBING CERTAIN PAIN MEDICATIONS. 2 1. The board of medicine shall amend the standards of 3 practice for appropriate pain management as established by rule 4 in 653 IAC 13.2, to specifically require all of the following: 5 a. That prior to issuing an initial prescription for a 6 controlled substance in schedule I or any opioid pain reliever 7 that is a prescription drug in a course of treatment for acute 8 or chronic pain, and prior to issuing a third prescription in 9 the same course of treatment, a physician shall discuss with 10 the patient, or the patient’s parent or guardian if the patient 11 has not reached majority as described in section 599.1, all of 12 the following: 13 (1) The risks of addiction and overdose associated with 14 opioid drugs and the dangers of taking opioid drugs with 15 alcohol, benzodiazepines, and other central nervous system 16 depressants. 17 (2) The reasons the prescription is necessary. 18 (3) Alternative treatments that may be available. 19 (4) The risks associated with the use of the drugs 20 being prescribed, specifically that opioids are highly 21 addictive, even when taken as prescribed, that there is a 22 risk of developing a physical or psychological dependence 23 on the prescription drug, and that taking more opioids than 24 prescribed, or mixing sedatives, benzodiazepines, or alcohol 25 with opioids, may result in fatal respiratory depression. 26 b. That the physician include a note in the patient’s 27 medical record, confirming that the physician has discussed 28 with the patient, or the patient’s parent or guardian, as 29 applicable, the information specified under subsection 1. 30 2. This section shall not apply to a prescription for a 31 patient who is at the stage in the progression of cancer or 32 other terminal illness when the goal of pain management is 33 comfort care including when the patient is receiving hospice 34 care from a licensed hospice or palliative care, or to any 35 -1- LSB 5806XS (4) 90 pf/ko 1/ 3

S.F. 2208 medications prescribed for use in the treatment of substance 1 use disorder or opioid dependence. 2 EXPLANATION 3 The inclusion of this explanation does not constitute agreement with 4 the explanation’s substance by the members of the general assembly. 5 This bill relates to the standards of practice for a 6 physician relating to the prescribing of certain pain 7 medications. 8 The bill requires the board of medicine to amend the 9 standards of practice for appropriate pain management as 10 established by rule in 653 IAC 13.2, to include specific 11 requirements. The requirements include both of the following: 12 1. That prior to issuing an initial prescription for a 13 controlled substance in schedule I or any opioid pain reliever 14 that is a prescription drug in a course of treatment for acute 15 or chronic pain, and prior to issuing a third prescription in 16 the same course of treatment, a physician shall discuss with 17 the patient, or the patient’s parent or guardian if the patient 18 has not reached majority, the risks of addiction and overdose 19 associated with opioid drugs and the dangers of taking opioid 20 drugs with alcohol, benzodiazepines, and other central nervous 21 system depressants; the reasons the prescription is necessary; 22 alternative treatments that may be available; and the risks 23 associated with the use of the drugs being prescribed, 24 specifically that opioids are highly addictive, even when taken 25 as prescribed, that there is a risk of developing a physical 26 or psychological dependence on the prescription drug, and that 27 taking more opioids than prescribed, or mixing sedatives, 28 benzodiazepines, or alcohol with opioids, may result in fatal 29 respiratory depression. 30 2. That the physician include a note in the patient’s 31 medical record, confirming that the physician has discussed 32 with the patient, or the patient’s parent or guardian, as 33 applicable, the information specified in the bill. 34 The provisions of the bill do not apply to a prescription 35 -2- LSB 5806XS (4) 90 pf/ko 2/ 3

S.F. 2208 for a patient who is at the stage in the progression of cancer 1 or other terminal illness when the goal of pain management is 2 comfort care including when the patient is receiving hospice 3 care from a licensed hospice or palliative care, or to any 4 medications prescribed for use in the treatment of substance 5 use disorder or opioid dependence. 6 -3- LSB 5806XS (4) 90 pf/ko 3/ 3