Staff Columnist

Iowa's new opioid law could make matters worse for some

Prescription monitoring programs could have unintended consequences, research shows

Gov. Kim Reynolds signs House File 2377, a comprehensive bill that addresses opioid abuse in Iowa, into law at the Mercy Medical Center in Dubuque on Monday. (Michaela Ramm/The Gazette)
Gov. Kim Reynolds signs House File 2377, a comprehensive bill that addresses opioid abuse in Iowa, into law at the Mercy Medical Center in Dubuque on Monday. (Michaela Ramm/The Gazette)

Gov. Kim Reynolds signed a bill this week meant to combat the impacts of opioid abuse in Iowa. It’s one of only a few major bills to emerge from the 2018 Legislature with overwhelming bipartisan support.

In fact, House File 2377 was the most popular piece of legislation in the Statehouse this year, drawing zero dissenting votes in either the Iowa House or Senate.

However, the new opioid law is more of a political victory than a substantive policy change. While there are a few worthwhile measures, policymakers largely prescribed the wrong remedy for what everyone agrees is a real and growing problem.

“In the past decade, opioid-related deaths have more than doubled, and will continue to rise unless we take action to reverse this heart-wrenching trend,” Gov. Kim Reynolds said during her Condition of the State address at the beginning of the legislative session earlier this year, calling on lawmakers to take action.

The number of opioid-related deaths in Iowa rose from 59 in 2005 to 180 in 2016, according to data from the Iowa Department of Public Health. Final figures on 2017 are not yet available, but officials expect the total to top 200. The number of Iowans admitted for opioid treatment also has risen sharply, from about 600 in 2005 to more than 2,200 in 2016.

Likewise at the national level, officials estimate the number of opioid overdose deaths grew 500 percent between 1999 and 2016.

Each of those deaths was preventable and all are heartbreaking. It’s obvious Iowa legislators were wise to take action to address such a lethal problem, but it’s far from certain the state’s new rules will make much difference.

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The law creates limited Good Samaritan protections for those who report overdoses, but it also requires physicians to log opioid prescriptions in a statewide monitoring program. That provision interferes with doctor-patient relationships, amid growing doubts about whether that’s sound policymaking.

A study published this month in the Annals of Internal Medicine raises questions about the effectiveness of prescription drug monitoring. Researchers at Columbia University reported the evidence such programs impact overdose numbers is “largely insufficient,” and may even have the unintended consequence of encouraging heroin use.

The prescription monitoring program creates an undue burden for physicians and patients who legitimately need opioid painkillers. If people abusing the system are cut off from prescription drugs, many will turn to far more dangerous street drugs, which have been found to be laced with even deadlier drugs.

Iowa’s opioid law does not authorize a needle exchange program, which had been considered earlier in the legislative session. Without that, this legislation does troublingly little address the growing use of intravenous drugs, which are associated with the spread of HIV and other infections.

Policymakers have an understandable urge to “do something” in the face of a crisis, but sometimes “something” ends up making the problem worse. If Iowans hope for a meaningful solution, important work remains to be done by next year’s Legislature.

l Comments: (319) 339-3156; adam.sullivan@thegazette.com

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