HSB 160 (LSB 2615YC (1) 91)

HOUSE FILE _____ 

BY  (PROPOSED COMMITTEE ON JUDICIARY BILL BY CHAIRPERSON HOLT)

A BILL FOR

An Act relating to the standards of practice relating to the prescribing of certain pain medications.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  BOARD OF MEDICINE —— STANDARDS OF PRACTICE FOR PRESCRIBING CERTAIN PAIN MEDICATIONS.
   1.  The board of medicine shall amend the standards of practice for appropriate pain management as established by rule in 653 IAC 13.2, to specifically require all of the following:
   a.  That prior to issuing an initial prescription for a controlled substance in schedule I or any opioid pain reliever that is a prescription drug in a course of treatment for acute or chronic pain, and prior to issuing a third prescription in the same course of treatment, a physician shall discuss with the patient, or the patient’s parent or guardian if the patient has not reached majority as described in section 599.1, all of the following:
   (1)  The risks of addiction and overdose associated with opioid drugs and the dangers of taking opioid drugs with alcohol, benzodiazepines, and other central nervous system depressants.
   (2)  The reasons the prescription is necessary.
   (3)  Alternative treatments that may be available.
   (4)  The risks associated with the use of the drugs being prescribed, specifically that opioids are highly addictive, even when taken as prescribed, that there is a risk of developing a physical or psychological dependence on the prescription drug, and that taking more opioids than prescribed, or mixing sedatives, benzodiazepines, or alcohol with opioids, may result in fatal respiratory depression.
   b.  That the physician include a note in the patient’s medical record, confirming that the physician has discussed with the patient, or the patient’s parent or guardian, as applicable, the information specified under subsection 1.
   2.  This section shall not apply to a prescription for a patient who is at the stage in the progression of cancer or other terminal illness when the goal of pain management is comfort care including when the patient is receiving hospice care from a licensed hospice or palliative care, or to any medications prescribed for use in the treatment of substance use disorder or opioid dependence.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to the standards of practice for a physician relating to the prescribing of certain pain medications.
   The bill requires the board of medicine to amend the standards of practice for appropriate pain management as established by rule in 653 IAC 13.2, to include the following:
   1. Prior to issuing an initial prescription for a controlled substance in schedule I or any opioid pain reliever that is a prescription drug in a course of treatment for acute or chronic pain, and prior to issuing a third prescription in the same course of treatment, a physician shall discuss with the patient, or the patient’s parent or guardian if the patient has not reached majority, the risks of addiction and overdose associated with opioid drugs and the dangers of taking opioid drugs with alcohol, benzodiazepines, and other central nervous system depressants; the reasons the prescription is necessary; alternative treatments that may be available; and the risks associated with the use of the drugs being prescribed.
   2. The physician must include a note in the patient’s medical record, confirming that the physician has discussed with the patient, or the patient’s parent or guardian, the information specified in the bill.
   The bill does not apply to a prescription for a patient who is at the stage of cancer or other terminal illness where the goal of pain management is comfort care.