Op-Ed Published in Newsday
By Eric T. Schneiderman
For as long as there have been prescriptions, there has been misuse of prescription drugs. But in recent years, abuse of prescription painkillers has exploded, leaving in its wake a trail of addiction and -- in too many cases -- violence.
That's why I pushed a new law here in New York State that created I-STOP -- the Internet System for Tracking Over-Prescribing -- to make our communities safer and to aid patients who get hooked on these highly addictive medicines.
And it's why I-STOP included a first-in-the-nation requirement that doctors and other health care providers check a real-time database before prescribing opioid pills.
That mandatory verification provision takes effect today, Aug. 27, the first anniversary of the date I-STOP became law -- and it should go a long way toward curbing this deadly trend.
The U.S. Centers for Disease Control and Prevention has declared prescription drug abuse an epidemic. Nationwide, enough pain pills were sold in 2010 to give every adult 5 milligrams of hydrocodone every four hours for a month. A federal study released just last month found a 400 percent rise in overdose deaths of women from prescription narcotics from 1999 to 2010.
In New York, a state with 19.4 million people, pharmacists filled 13 million prescriptions for oxycodone, hydrocodone and other addictive drugs in 2012.
In New York City, 2.2 million prescriptions for oxycodone, hydrocodone and similar drugs were written in 2011, up 31 percent from 1.6 million in 2008. In Nassau County, the number of oxycodone prescriptions written increased 42 percent from 2008 to 2010.
Overdose deaths from narcotic painkillers in the city jumped 65 percent from 2005 to 2011. Last year on Long Island, there were more fatal overdoses from oxycodone than heroin.
Despite these disturbing numbers, there is some good news: Newsday recently reported a 9 percent drop in the number of narcotics prescriptions on Long Island between 2012 and 2011. There are a number of reason for this, among them stronger federal, state and local law enforcement actions -- including by my office's Medicaid Fraud Control Unit. But we must continue to take decisive measures to choke off this dangerous epidemic.
Doctor-shopping drug dealers bounce from waiting room to waiting room looking to buy prescriptions for hundreds of dollars each. And a small number of unscrupulous doctors are willing to oblige -- white-coated physicians feeding the black market.
In just the past month, a Long Island doctor was arrested on charges of writing prescriptions for powerful painkillers for cash during nearly 5,800 patient visits in 2011 and 2012 -- raking in $1.4 million -- and in Dutchess County, Dr. Arnold Roth pleaded guilty to selling prescriptions for more than 16,000 oxycodone pills with a street value of $480,000.
Another Long Island doctor, Saji Francis, went to prison last year after a patient, Timothy Kroll, died of a heart attack at 23. He had gone to Francis for treatment of migraines and was prescribed large amounts of oxycodone, which led to an addiction to cocaine and, ultimately, heroin.
Kroll became a powerful symbol of a crisis out of control. But innocent patients aren't the only victims; crimes committed by users desperate for pills have also taken a bloody toll. In 2011, for example, four people were shot dead at a Medford pharmacy by a robber who stole 10,000 pain pills.
I-STOP can help stem the tide. Starting Aug. 27, 50,000 New York doctors, physician assistants and nurse practitioners will have to check the database before prescribing powerful medications -- and pharmacists will have to enter into it every opiate prescription they fill. This will send up a red flag if a doctor-shopper is hoarding pills and warn of potential drug interactions with other medications that legitimate patients may be taking.
Longer term, New York will mandate electronic prescribing, eliminating paper prescription pads -- and the possibility of forging orders for dangerous drugs.
These safeguards are so important that New York's Legislature unanimously passed I-STOP by a combined Assembly and Senate vote of 174-0.
Across the country, hospitals are inundated by addicts they cannot care for because there simply are not enough treatment beds. Detox is time-consuming and expensive, with no guarantee of success.
It is far better to prevent addiction than try to treat it after a patient gets hooked. I-STOP is a strong step in that direction.