PHARMACIST STEVE

Doctors in Iowa will be required to screen patients’ risk of addiction before prescribing some painkillers under a law signed Monday by Gov. Kim Reynolds.

The law, an attempt by lawmakers to curb Iowa’s growing opioid problem, mandates the tracking of prescription drugs through a software system that should automatically flag patients believed to have a high risk of abusing painkillers. The measure seeks to reduce so-called “doctor shopping,” where a patient visits multiple physicians seeking prescriptions.

Reynolds signed the law at a Dubuque medical center that offers treatment for opioid addiction.

“Opioid-related deaths have more than doubled over the past decade,” the Republican governor said. “With this legislation, we are taking the first step to reverse this heart-wrenching trend.”

Medical experts warn the state must be careful to avoid a spike in illegal drug use, an unintended consequence of limiting opioid medication.

Lawmakers have taken some steps in recent years to address opioid abuse. In 2016, they expanded access to a drug used to treat overdoses. Grants also are increasing access to treatment for those addicted to opioids. But there’s been a push to do more as opioid-related deaths increase.

Opioid patients will now be assigned a number similar to a credit score that indicates their risk for abusing opioids — which include prescription pain relievers, such as oxycodone, and illegal substances, such as heroin. High risk patients would be scrutinized by doctors and pharmacists.

“The higher the number, the higher the risk,” said Andrew Funk, executive director of the Iowa Board of Pharmacy.

Iowa will join 38 other states that require the use of a prescription monitoring program, according to the National Alliance for Model State Drug Laws. Iowa’s neighboring states of Minnesota, Wisconsin and Illinois have mandatory review programs. Nebraska and South Dakota have optional programs, while Missouri lacks a robust statewide program.

Prescription management programs need to be linked to other efforts to combat opioids, said Silvia Martins, a Columbia University assistant professor who co-authored a recent study examining whether such programs decrease overdose deaths. The study, published earlier this month, encouraged states to have mandatory programs like Iowa’s where doctors review patient data before writing prescriptions. Providing adequate access to treatment is also critical.

“It has to be a multipronged approach,” Martins said.

States can’t only focus on legal access to opioids. Martins said some states see a spike in heroin overdose deaths after taking steps to reduce legal prescriptions for opioids.

Iowa had 98 deaths linked to heroin last year, part of 309 overall opioid-linked deaths, based on preliminary data from the Iowa Department of Public Health. Iowa had more than 50 opioid-linked deaths in the first four months of 2018. Nationally, more than 115 people die each day from opioid overdoses, according to the Centers for Disease Control and Prevention.

The law, which goes into effect in July, also provides immunity from prosecution to anyone who calls 911 to report an overdose.

Critics question whether Iowa’s opioid legislation goes far enough. The new law doesn’t place any limits on how many doses of opioids can be prescribed or directly address the spread of illicit drugs.

Democrats unsuccessfully attempted to add a needle exchange program, which could help slow the spread of hepatitis C and HIV from illicit drugs. State Epidemiologist Patricia Quinlisk said such programs are a “proven method” to get people with drug addiction into treatment.

Rep. David Heaton, a Mount Pleasant Republican who isn’t seeking re-election, said he’s also concerned that the private companies that run Iowa’s Medicaid system “drag their feet” on providing authorization for medicine to help curb addiction.

“My hat’s off to all of us on passing a good start,” Heaton said in floor debate. “But there’s a lot of work to be done.”