DUBUQUE — Calling it a move that “represents a significant step forward in Iowa’s efforts to address the opioid epidemic,” Gov. Kim Reynolds signed into law a comprehensive bill Monday that aims to combat the growing problem.
Through several provisions, House File 2377 aims to address the problem of opioid abuse and addiction at several angles, but particularly from the standpoint of curving prescription abuse.
The tone from the governor, as well as legislators present, is that this is just the initial phase in combating opioid abuse and addiction in the state.
“I think it’s a big step in the process,” Reynolds told reporters after the signing. “We need to continually be looking for ways to enhance, but this is a significant step.”
Reynolds said the law is designed to reduce the number of prescription opioids in communities, which experts nationally have pointed to as the catalyst of the U.S. opioid crisis.
Reynolds signed the bill at Mercy Medical Center in Dubuque, which houses the Mercy Turning Point Treatment Center — a substance abuse program touted during the event.
“What we’re trying to do is deal with those who are addicted to prescription drugs,” said Sen. Pam Jochum, D-Dubuque. “The bill was really built on some of the success stories that we have experience in our own state and the Dubuque community.”
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Among its provisions, the new law requires prescribers — doctors, dentists, nurse practitioners and veterinarians — to register for the prescription monitoring program, an online database that will receive funding from this bill.
Once registered, prescribers will be required to report any controlled substance they give to patients in the program. They also must check the database before issuing an opioid prescription to a patient to determine if that individual is doctor shopping — visiting multiple doctors to obtain more prescriptions.
“This goes a long ways in just seeing if there’s inconsistencies or overprescribing,” Reynolds said. “It would help identify that and help discourage that.”
Beginning Jan. 1, 2020, every prescription issued for a controlled substance will be issued electronically, rather than on a paper prescription — a practice that allowed some to tamper with their prescription amount.
FINDING A BALANCE
Patients who take opioid pain killers to manage their chronic pain have expressed their concerns to The Gazette that laws meant to curb abuse could cut off their prescriptions.
Reynolds on Monday said it’s still important to monitor those prescriptions because they are so addictive. While doctors need to have the flexibility to offer the treatment they believe is right for the patient, she also encouraged alternative methods for chronic pain.
“It’s a balance like anything else,” she said.
The bill also includes a Good Samaritan provision, which offers immunity from some civil, criminal or professional liability to a person calling 911 to seek help for a drug overdose and for the person experiencing the overdose. It includes an exception for drug dealers and repeat offenders.
Eighty-six opioid overdose deaths occurred in 2016, according to the Iowa Department of Public Health — nearly three times the number of overdose deaths a decade earlier.
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However, Iowa did well in a report released Monday by WalletHub, the personal finance company, that tracked the drug problem. With No. 1 being the worst, Iowa was 50th among all states and the District of Columbia in several categories, including the number of opioid pain relievers per 100 people, drug arrests per capita and overdoses per capita.
Monday’s “first step” in addressing the state’s opioid crisis is significant, said Rep. Dave Heaton, R-Mount Pleasant, but state lawmakers’ next move needs to focus on ensuring adequate treatment for individuals who already are dealing with addiction.
“(We need) to ensure they can get treatment and the right kind of treatment. That’s going to take a lot of work because there aren’t many facilities available in this state,” Heaton said.
Sen. Michael Bergen, R-Dorchester, said lawmakers also need to take the legislation further to address the issue of illicit opioid drugs, such as heroin or fentanyl.
Allowing needle exchange programs — they offer clean needles to drug users in exchange to keep levels of hepatitis C and other disease down — was discussed during the legislative session, but ultimately was not included in the bill.
“We haven’t come to a consensus if its an appropriate mechanism, but we are looking at that as an option and looking to other states’ models,” Bergen said.
“I’d advocate for a needle exchange program through a treatment program so that it allows users an opportunity for intervention.”
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