The Iowa legislature recently passed a bill, which was signed into law, which provides expanded access to opioid antagonists to combat the opioid overdose epidemic. The law contains two components to provide this greater access.

First, Iowa Code now allows a pharmacy to dispense an opioid antagonist pursuant to a prescription issued in the name of a law enforcement agency, fire department, or EMS program. The board has proposed an amendment to its rule regarding the requirement of a valid patient-prescriber relationship that would provide an exemption for such dispensing. Until the amendment can be adopted, the board will not take enforcement action against a pharmacy that dispenses an opioid antagonist to such entity when acting in good faith in accordance with Iowa Code.

Second, Iowa Code now authorizes a pharmacy to dispense an opioid antagonist under a standing order or collaborative practice agreement to a person in a position to assist someone at risk of an opioid-related overdose. Board staff has been working with the Iowa Department of Public Health to develop a statewide standing order for dispensing naloxone. The standing order authorizes an individual to obtain naloxone that is 1) the person at risk of an opioid-related overdose, 2) a family member or friend of a person at risk, 3) a person in a position to assist a person at risk, or 4) a first responder.

The board has also proposed rules, currently in the comment period, which identify training and education requirements for pharmacists who wish to dispense under such standing order, the training and education to be provided to the recipient of the naloxone, and reporting and records requirements. The proposed rulemaking can be found at https://rules.iowa.gov/Notice/Details/2721C. The board intends to file the rulemaking with emergency adoption, if possible, which would potentially make the rules effective early in November.

A pharmacy that is interested in dispensing naloxone under the statewide standing order can be prepared with these actions:

Review the board’s website for important information relating to naloxone and the statewide standing order

Interested pharmacists complete a one-hour continuing education course on opioid antagonist utilization (the board’s website will include links to several free courses).

Compile educational materials to provide to individuals that will receive naloxone, including instructions on the administration of naloxone and information about substance abuse or behavioral health treatment programs in the area.

Download the statewide standing order for the pharmacy’s records for authorized pharmacists to sign.

Download the Recipient Eligibility Assessment form.

Develop policies and procedures for dispensing naloxone under the standing order and ensure staff is trained on procedures.

Determine which naloxone product(s), as identified in the statewide standing order, the pharmacy will offer for dispensing. The pharmacy is not required to provide all three products.

For more information, contact Sue Mears.