Efforts to curb opioid abuse focus on monitoring database

Measures try to keep better track of powerful painkiller prescriptions

OxyContin, in 80 mg pills. (file photo)
OxyContin, in 80 mg pills. (file photo)

DES MOINES — As opioid overdoses continue to be on the rise in Iowa, health care professionals across the state are looking to this year’s legislative session to stem the epidemic.

Legislation concerning Iowa’s Prescription Monitoring Program is making its way through the Capitol to help address the spike in overdose-related deaths.

“People are going to abuse drugs, that’s just part of society,” said Sen. Tom Greene, R-Burlington. “There’s going to be those out there who push the envelope all the time. Hopefully this limits the illegal diversion of legitimate medication, and that’s really what we’re after.”

Proposed legislation would make it more difficult for individuals abusing opioids to get hold of prescriptions, thanks to possible changes in the monitoring program.

An online portal implemented in 2009, the program is a repository of controlled substance prescriptions dispensed to patients by pharmacies in Iowa and pharmacies shipping to the state.

On Thursday, House Republicans unveiled bill that would, among other things, require doctors and pharmacists to register with and check the electronic state database when prescribing and issuing opioid painkillers.

The bill meant to limit doctor shopping also would prohibit filling opioid prescriptions over 60 days old.


Separately, the Iowa Board of Pharmacy has put forth a bill that would expand reporting requirements to prescribers supplying controlled substances to their patients.

Pharmacy board Executive Director Andrew Funk emphasized this bill is not a mandate for all prescribers to use the program, but rather requires those who dispense controlled substances to patients without the use of a pharmacy to log that information.

“There are some physicians that rather than give a prescription to a patient may decide to dispense the drug directly,” he said. “We want to capture any of that activity.”

The opioid epidemic is complex issue, but experts agree part of it stems from overprescribing to those with chronic pain issues.

Right now, Funk said about 46 percent of eligible prescribers — including doctors, dentists and other providers — are registered on the monitoring program. But, Funk said, only about 80 of those providers actually log information in.

Dennis Tibben, director of government affairs for the Iowa Medical Society, said state officials could encourage more use of the Prescription Monitoring Program if certain changes were made within the system.

“As that tool becomes more functional and the records are better and more timely, we really expect the utilization from prescribers is going to go up significantly,” Tibben said.

Tibben said the low usage can be attributed to the fact that the system hasn’t had major updates since 2009 and doesn’t integrate well with electronic health records. The pharmacy board has an update for the monitoring program scheduled to go live in April, Funk said.


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Pharmacies report information only about once a week, which creates a lag in accurate information for the physician, Tibben said.

The pharmacy board also is in the process of changing this rule and will require pharmacies to report dispensing information every business day, Funk said.

But Stephanie Fawkes-Lee, a lobbyist and a critic of the board’s proposed legislation, said this proposal also limits access for those who are dealing with chronic pain and need the medication for quality of life.

Greene emphasized the bill wouldn’t impact those who truly need the medication, but the state needs “to do what we can to be proactive and curb the illegal use of these opioid products.”

Despite these measures, some critics maintain that state leaders are not taking the right steps to address the opioid epidemic and should instead focus on rehabilitation for those addicted.

“Bottom line: If Iowa had a good program for long-term recovery (for drug users), we wouldn’t have to do any of these things,” Fawkes-Lee said.

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