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Post date: June 11 2012

A.G. Schneiderman's Landmark I-STOP Bill To Curb Rx Drug Abuse Unanimously Passes NYS Legislature

First-In-The-Nation Law Will Require Doctors To Check Patient Prescription History And Pharmacists To Update Database In Real Time

New York Will Be One Of The First To Implement E-Prescribing Of Controlled Substances, Ending Abuse Of Forged Or Stolen Scripts

Schneiderman: I-STOP Is A National Model For Fighting Prescription Drug Abuse

ALBANY — Attorney General Eric T. Schneiderman today announced the Legislature has unanimously passed the Internet System for Tracking Over-Prescribing Act, or I-STOP, 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 - the first joint Attorney General-Governor program bill in recent memory - overwhelmingly passed the Assembly by a margin of 116-0 and the Senate 58 to 0.

“This is a major victory for the people of New York. 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,” Attorney General Schneiderman said. “I applaud the Legislature for taking action to curb the prescription drug crisis that has impacted families in every corner of this state, and Governor Cuomo for his leadership and commitment to signing I-STOP into law. Now, New York will be a national leader in protecting the public from the devastating consequences of prescription drug abuse.”

Among the features of groundbreaking legislation passed today:

  •  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;
  •  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 non-crisis 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.

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.

Assemblyman Michael Cusick (D-Staten Island) said, “The information gap between doctors and pharmacists allows addicts and abusers to slip through our regulatory cracks. Only a real time system like I-STOP will fix it. To best protect the public, medical professionals must be able to update records of controlled substance prescriptions when they are written or filled. This legislation is the best solution to ensure patients receive the medication they need, and those who profit off of abuse receive the justice they deserve.”

Senator Andrew J. Lanza (R-Staten Island) said, “This legislation allows our physicians and pharmacists to access real-time prescription histories to ensure that patients' prescription use is legitimate - not lethal. We are doing away with the state’s outdated monitoring system, and will now have a modern database that is updated in real time so that no addict or criminal slips through undetected. I am proud to have sponsored this legislation with the Attorney General to give medical professionals the tools they need to improve health care service, stop prescription drug abuse, and most importantly, save lives.”

Nassau County Executive Edward P. Mangano said, “Attorney General Schneiderman jump started the conversation in Albany about the prescription drug abuse problem and brought together the medical community, law enforcement officials, treatment providers and family members of abuse victims to determine the best possible policy solution to this growing epidemic. I am proud that Senator Majority Leader Skelos, Speaker Silver and the Legislature will pass the strongest laws yet of any state to combat this scourge on our communities. New York is once again setting the example for the rest of the nation on an issue of grave importance."

Westchester County District Attorney and President of the District Attorneys Association of the State of New YorkJanet DiFiore said, “The abuse of prescription drugs throughout our State is no better illustrated than by the rising numbers emergency room admissions for prescription drug overdoses. The District Attorneys Association of the State of New York supports Attorney General Schneiderman’s legislation that now will greatly enhance the State’s Prescription Monitoring Programs and for helping law enforcement cut off the supply of prescription drugs to the black market by getting the I-STOP bill passed.”

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.”

“This is another story of people and perseverance driving meaningful policy," said Congressman Brian Higgins, who led a federal delegation letter in support of I-STOP. "People like Avi and Julie Israel and others behind the 'Save the Michaels of the World' cause stood up and fought for change to stop the growing prescription drug epidemic. I am proud to stand with them, and to commend Attorney General Schneiderman and other state leaders who fought to see that today's electronic health technology is utilized to prevent future tragedies."

Senator Tim Kennedy, D-Western New York, said, “This is a major victory for the families of this state who understand first-hand the devastation of prescription drug abuse. The grieving mothers and fathers, who bravely shared the stories of their children lost to this epidemic, have driven this cause forward. We owe a debt of gratitude to Attorney General Schneiderman for taking action to address this growing crisis that is hitting our communities hard. I-STOP is the right solution to curb the skyrocketing number of overdoses, robberies and murders connected to prescription drugs in recent years, and I am proud to have been an early supporter of it.”

Andrew Kolodny, MD, President of Physicians for Responsible Opioid Prescribing, said, “Creating a system that lets us view narcotic prescriptions for our patients and requiring us to use it is before we prescribe is a powerful public health intervention. I’m confident that it will help bring the epidemic of painkiller addiction and overdose deaths under control. Attorney General Schneiderman and other state leaders came up with an innovative and balanced policy that effectively limits black market availability of prescription narcotics and helps us identify patients suffering from the disease of addiction. At the same time, it preserves access for patients who need these medications. This is going to save lives.”

Avi Israelsaid, “Monday was the anniversary of my son’s death and, although he isn’t here to benefit from this important legislation, I want to thank Attorney General Schneiderman for all his efforts in getting I-STOP passed. With this new system, many families will be spared the tragic loss ours has experienced. With the implementation of mandatory patient history reviews and e-prescribing, doctor-shopping and overprescribing will be no longer possible, and young people like my son Michael will now be saved.”

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.”

Dr. Jeffrey Reynolds, Executive Director of Long Island Council on Alcoholism and Drug Dependence said, “I-STOP will help both law enforcement and the medical community get a handle on the fast-growing prescription drug problem in New York State. Most importantly, it will save lives. Attorney General Schneiderman's prescription drug abuse report documented the alarming spike in addiction, and the tragic deaths associated with prescription drug abuse. With I-STOP's passage assured, we will have a system in place that will start to solve this devastating problem.”

Dr. Thomas Jan, DO, Massapequa Pain Management said,“Over the course of the past ten years I have seen the devastating destruction wrought by prescription abuse but I have also seen appropriate prescribing give a lease on life for those afflicted by chronic pain. At last, with Attorney General Schneiderman's I-STOP legislation we can start to address that devastation while ensuring that those who are afflicted receive appropriate treatment. With a complete and accurate prescription history, we can now offer pain relief with confidence and also identify those suffering from addiction so they may receive the treatment they need."
Dr. David Kim, Executive Director of Beacon Christian Community Health Center said, "Prescription drug abuse is a growing crisis on Staten Island and across the state. I applaud the leadership of Attorney General Schneiderman, the Governor's office, Assemblyman Cusick and State Senator Lanza in meeting with the pharmaceutical and medical communities to collaboratively address this issue. The I-STOP plan is a critical first step for doctors, pharmacists and patients in the combat against prescription drug abuse. It is a great example of all stakeholders coming together and working constructively to address this epidemic, saving meaningful lives from being wasted, or even lost."

Norwig Debye-Saxinger, President of Treatment Communities of America, said, “As treatment providers on the front lines of this crisis, we see every day the devastation that these drugs can cause to our families and communities. With these new measures in place, we are confident that New York will now be armed with the right set of tools to confront this problem and start reversing the upward trend of prescription drug abuse. We thank Attorney General Eric Schneiderman for his leadership on this issue and for taking into consideration the needs of treatment centers. We hope that other states will now follow New York's lead and pass similar legislation.”

A copy of the Internet System for Tracking Over-Prescribing (I-STOP) Act can be read here