A.G. Schneiderman On Long Island To Detail Landmark I-STOP Legislation To Curb Rx Drug Abuse

MINEOLA — Following the unanimous passage of the I-STOP plan, Attorney General Eric T. Schneiderman today was joined by a coalition of local families, doctors, pharmacists and elected officials to detail the impact of the new legislation on Long Island. The Internet System for Tracking Over-Prescribing Act is set to become a national model for other states and Congress to follow to curb prescription drug abuse, the nation’s fastest growing drug problem. Introduced in June of 2011 by Attorney General Schneiderman, I-STOP is an online database that enables doctors and pharmacists to report and track controlled narcotics in real time. The bipartisan legislation is the first joint Attorney General-Governor program bill in recent memory.

“This is a major victory for the people of Long Island and families across the state. With I-STOP, we are creating a national model for smart, coordinated communication between health care providers and pharmacists to better serve patients, stop prescription drug trafficking, and provide treatment to those who need help,” said Attorney General Schneiderman. “I applaud the families, advocates and lawmakers for taking action to curb the prescription drug crisis that has impacted communities in every corner of this state, and Governor Cuomo for his leadership and commitment to signing I-STOP into law. New York is now leading the nation in protecting the public from the devastating consequences of prescription drug abuse.”

Among the features of groundbreaking legislation:

• I-STOP will make New York the first state in the nation to mandate that physicians consult a database of a patient's prescription history before prescribing a schedule II, III, or IV controlled substance. Accurate patient histories and better training will help physicians detect doctor shoppers and better serve patients at risk of addiction. Doctors can also use this information to avoid potentially dangerous drug interactions.
• I-STOP will make New York the largest, and only second state in the nation, to require real-time reporting by pharmacists when schedule II, III, IV or V prescriptions are filled.
• I-STOP will make New York one of the first states to schedule the universal mandate of e-prescribing for controlled substances in December of 2014. The regulations will be promulgated by December 2012. This will nearly eliminate the problem of forged or stolen prescriptions—used both by addicts, and criminal organizations obtaining pills to resell on the street.
• I-STOP will reschedule hydrocodone to Schedule II, ending automatic refills for this highly abused drug.
• I-STOP will schedule tramadol, a 'drug of concern' to Schedule IV (it is currently unscheduled).
• I-STOP will establish a safe disposal program providing a place for New Yorkers to get rid of expired and unneeded drugs to ensure that they are not left in medicine cabinets for children or addicts to access.

I-STOP will also deter fraud against private health insurers and the state government. Taxpayers have been paying for a substantial portion of the over-prescribed pills through the Medicaid program. Each ring of collusive patients and prescribers prosecuted by the Attorney General’s Medicaid Fraud Control Unit represented a loss to the State of at least $1 million.

Attorney General Schneiderman first introduced the I-STOP bill last June.

In January of this year, the Attorney General released a report detailing the scope of the prescription drug epidemic in New York State and demonstrating the need for action by the Legislature. According to the Attorney General’s report:

• Statewide prescriptions for hydrocodone have increased 16.7 percent, while those for oxycodone have increased an astonishing 82 percent between 2007 and 2009;
• 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;
• On Long Island, both crisis and non-crisis admissions to drug treatment that involve cocaine and opiates other than heroin have increased at alarming rates. In Nassau and Suffolk Counties, admissions increased 57 percent and 40 percent, respectively, for crisis admissions from 2007 to 2010.
• Non-crisis admissions are even more shocking – such admissions increased almost 70 percent in Nassau County, and nearly 80 percent in Suffolk County over the same time period. Since 2006, oxycodone has contributed to more deaths than any other prescription opioid in Nassau County, and the prescriptions for the drug increased 42 percent from 2008 to 2010. Suffolk County saw prescriptions for oxycodone increase 23 percent during the period.

In the spring of 2011, Newsday reported that as many as 1.4 million scripts had been stolen since 2008 from several different hospitals within the New York City Health and Hospital Corporation, the city’s public hospital system. Most of the fake scripts were written for oxycodone. In the fall of the same year, DOH confirmed that another 14,000 blank prescriptions were missing from Westchester County’s Mount Vernon Hospital.

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. 

Leaders in law enforcement, the medical community, the Legislature, as well as parent advocates, praised Attorney General Schneiderman’s critical role in shepherding the bill to passage. I-STOP is supported by U.S. Senator Kirsten Gillibrand, as well as a bipartisan coalition of 24 U.S. Representatives from across New York State, 20 addiction treatment provider organizations, the District Attorneys Association of the State of New York, New York State Association of Chiefs of Police, New York State Association of PBA's, and the Police Benevolent Association of the New York State Troopers, Inc.

Teri Krollsaid, “I know firsthand that there is nothing as painful as losing a child. Now, with this new system, I am confident that doctors will now prescribe more responsibly and many parents won’t have to share that grief.”

Jordan Fogel, owner and pharmacist at Linden Care in Syosset, said, "I applaud the Attorney General and his staff for their leadership in getting I-STOP passed. Now safeguards must be put in place to curb the drug crisis. Pharmacist’s need immediate access. Doctor’s should have quantity & dosing limits, with exceptions for chronic pain syndrome patients. Only MD’s and pharmacists certified in pain management should prescribe and dispense highly abusive meds. Too many doctors prescribe out of the scope of their practice. Insurance companies need to be more responsible. Manufacturers and distributors need to tighten distribution channels. I-STOP has great Provisions in E prescribing , new drug classes and safe disposal. I-STOP is a win-win for New York State, we now need to ensure the bill is armed with the right set of tools."

Nassau County Executive Edward P. Manganosaid, “The new registry will help save lives by preventing overprescribing of medications, reducing the flow of pharmaceuticals to drug traffickers, and assisting in the identification and treatment of patients who are at risk of addiction. This is a giant leap forward, yet there is more to do in this war on prescription drug abuse.”

Nassau County District Attorney Kathleen Ricesaid, “The scourge of prescription drug abuse impacts every segment of society. I-STOP will be a potent tool to take on dirty doctors and pharmacists who put profit before patients, while helping identify addicts so they can receive the treatment they need. This legislation will save lives, and I applaud Attorney General Schneiderman for his leadership on this critically important public safety issue.”

Dr. Jeffrey Reynolds, Executive Director of Long Island Council on Alcoholism and Drug Dependencesaid, “We very much appreciate Attorney General Schneiderman’s tireless leadership in making ISTOP a reality and we thank the Legislature for acting with such unanimity. With the advent of ISTOP, doctors and pharmacists will be better equipped to sort out the doctor shoppers and pharmacy hoppers, while at the same time ensuring that those with legitimate needs have appropriate access to life-enhancing medications. With concrete facts in hand, prescribers and dispensers can begin to say “no” to those who are misusing and diverting prescription medications and that refusal – especially when it grows into a chorus led by health care professionals - can create an opportunity for change in those struggling with addiction.”

Dr. Thomas Jan, DO, Massapequa Pain Managementsaid, “Thanks to Attorney General Schneiderman and the New York State Legislature we now have a chance at reversing the tide of this prescription drug epidemic with the I-STOP legislation. Now that we are getting a powerful tool to help us treat our patients, we need to remember that when addiction is identified it is up to us, the medical community, to reach out and help.”