2012-01-13 / Top Stories

Schneiderman Report Aims To Address RX Crisis

Detailing the growing prescription drug abuse epidemic in New York State and nationwide, Attorney General Eric T. Schneiderman issued a report that illustrates the need for legislation to create an online, real-time database to report and track both the prescribing and the dispensing of certain controlled substances. The report was praised by a broad, bipartisan coalition of law enforcement officials, lawmakers and health care experts who called on the state Legislature to pass the Attorney General’s proposal in the coming weeks.

In 2011, Schneiderman unveiled the “Internet System for Tracking Over- Prescribing Act,” or “I-STOP” legislation, to provide health care practitioners and pharmacists with centralized information to avoid over-prescribing, help shut down prescription drug trafficking, and identify and treat patients who seek to abuse prescription drugs. Schneiderman’s program bill expands on a proposal made by Assemblyman Michael Cusick, who is sponsoring the bill in the Assembly. In the Senate, the bill is sponsored by Andrew J. Lanza.

“The prescription drug abuse crisis in New York and across the country has reached epidemic proportions. Today’s report illustrates how this growing problem demands a better solution for both our health care providers and law enforcement officials to track the flow of potentially dangerous substances. Inaction is not an option,” Schneiderman said. “I-STOP uses real-time, online technology to streamline communication between health care providers and pharmacists to better serve patients, stop prescription drug trafficking, and provide treatment to those who are addicted. The time to act is now.”

The Attorney General’s report details the growing prescription drug abuse crisis in every corner of New York State – from the North Country to Long Island. Statewide, the number of prescriptions for all narcotic painkillers has increased by six million, from 16.6 million in 2007 to nearly 22.5 million in 2010. Contributing to the problem are a lack of communication between practitioners, which significantly increases the likelihood of over-prescribing and dangerous drug interaction; and access to an ever-increasing supply of prescription narcotics, through legal or illegal means, which has grown four-fold in the past decade.

Prescription drug abuse is the country’s second most prevalent illegal drug problem, and recent reports and studies have documented corresponding data in the state. For example:  Statewide prescriptions for hydrocodone have increased 16.7 percent, while those for oxycodone have increased an astonishing 82 percent;  In New York City, the rate of prescription pain medication misuse among those age 12 or older increased by 40 percent from 2002 to 2009, with nearly 900,000 oxycodone prescriptions and more than 825,000 hydrocodone prescriptions filled in 2009;  In Buffalo, New York’s largest methadone clinic outside of New York City, Catholic Health System has begun to reorganize its service to accommodate an increase in care needed to treat the number of opiate-addicted expectant mothers and newborns;

On Long Island, both crisis and noncrisis admissions to drug treatment that involve opiates other than heroin and have increased at alarming rates. Between 2004 and 2009, the number of deaths due to the toxic effects of prescription opioids more than tripled in Nassau County; and  In the North Country, health care facilities have experienced a staggering increase in the percentage of non-crisis admissions for substance abuse involving prescription narcotics, eclipsing cocaine and heroin in Clinton and Franklin Counties, and surpassing even marijuana in St. Lawrence County.

New York’s current prescription monitoring program requires pharmacists to report controlled substances they dispense at least once every 45 days. There is no tracking of prescriptions written and there is no mechanism whatsoever for pharmacists to ensure that a prescription presented is valid.

I-STOP will vastly enhance the effectiveness of the present system. Its goal is to enable doctors and pharmacists to provide prescription pain medications, and other controlled substances, to patients who truly need them. At the same time, it will arm them with the necessary data to detect potentially dangerous drug interactions, identify patterns of abuse by patients, doctors and pharmacists, help those who suffer from crippling addictions and prevent potential addiction before it starts.

Attorney General Schneiderman’s ISTOP legislation:  requires the Department of Health to establish and maintain an online, realtime controlled substance reporting system to track the prescription and dispensing of controlled substances;  requires practitioners to review a patient’s controlled substance prescription history on the system prior to prescribing;  requires practitioners or their agents to report a prescription for such controlled substances to the system at the time of issuance;  requires pharmacists to review the system to confirm the person presenting such a prescription possesses a legitimate prescription prior to dispensing such substance; and  requires pharmacists or their agents to report dispensation of such prescriptions.

These enhancements of the state’s prescription drug monitoring program are all necessary to assist in patient care by providing a doctor with a patient’s accurate and up-to-date controlled substance prescription history; eliminate the problem of stolen and forged prescriptions being used to obtain controlled substances from pharmacies; crack down on illegal ‘doc-shopping,’ the practice of visiting several different doctors and pharmacies for prescription drugs; facilitate prosecutions of crooked doctors; and achieve significant savings for public and private health insurance programs. Prescription drug monitoring programs operate in 43 states.

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