The bill mandates the Iowa Board of Medicine to revise the standards of practice for prescribing certain pain medications, specifically opioids and controlled substances in schedule I. It requires physicians to engage in a detailed discussion with patients, or their guardians if the patient is a minor, before issuing an initial prescription or a third prescription in a treatment course for acute or chronic pain. This discussion must cover the risks of addiction and overdose, the necessity of the prescription, alternative treatment options, and the specific risks associated with opioid use, including the potential for dependence and fatal respiratory depression when combined with other substances.

Additionally, physicians are required to document this discussion in the patient's medical record. However, the bill exempts prescriptions for patients in advanced stages of cancer or terminal illnesses where the focus is on comfort care, as well as medications prescribed for treating substance use disorders or opioid dependence. This legislation aims to enhance patient safety and awareness regarding the risks associated with opioid medications.