Recently Gov. Cuomo issued a press release announcing a significant
prescription drug reform package. The measures outlined by the agreement
address several of the largest concerns that are often raised regarding
prescription drug abuse, including forged prescriptions, doctor
shopping, overuse of hydrocodone, youth access to prescription drugs,
and educating providers about the proper balance of pain management with
abuse prevention.
Here is the press release in its entirety:
Andrew M. Cuomo - Governor
Governor Cuomo, Attorney
General Schneiderman, and Legislative Leaders Announce Agreement to Make
New York State a National Leader in Fighting Prescription Drug Abuse
Albany, NY
(
June 5, 2012)
Governor
Andrew M. Cuomo, Attorney General Eric Schneiderman, Senate Majority
Leader Dean Skelos, and Assembly Speaker Sheldon Silver today announced a
landmark agreement on a comprehensive prescription drug reform package
that will make New York State a national leader in curbing prescription
drug abuse.
The new law will include a series of provisions to overhaul the way
prescription drugs are distributed and tracked in New York State,
including enacting a “real time" prescription monitoring registry
to provide timely and enhanced information to practitioners and
pharmacists; requiring all prescriptions to be electronically
transmitted; improving safeguards for the distribution of specific
prescription drugs that are prone to abuse; charging a workgroup of
stakeholders with the responsibility to help guide the development of
medical education courses and other public awareness measures regarding
pain management and prescription drugs; and requiring the Department of
Health to establish a safe disposal program for unused medications.
"This landmark agreement will help put a stop to the growing number
of fatalities resulting from overdoses on prescription drugs," Governor
Cuomo said. "We have seen too many untimely deaths as a result of
prescription drug abuse, and today New York State is taking the lead in
saying enough is enough. I commend Attorney General Schneiderman,
Majority Leader Skelos, and Speaker Silver for their hard work in
putting together this groundbreaking reform package that will help
protect New Yorkers and put an end to prescription drug abuse."
Attorney General Eric Schneiderman said, "This is a major victory for
the people of New York. With I-STOP, we will create 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. I applaud the
Governor, Assembly and Senate for agreeing to take action and curb the
prescription drug crisis that has impacted families in every corner of
this state. Now, New York will be a national leader in protecting the
public from the devastating consequences of prescription drug abuse."
Senate Majority Leader Dean Skelos said, "The effects of prescription
drug abuse are being felt all across this state, especially among young
people who are using painkillers to disastrous consequences. I commend
Senator Lanza, who has championed this bill for more than three years,
and Senator Hannon, the Chairman of the Senate Health Committee, for
recognizing early on that a legislative remedy was a critical and
necessary step. I thank the Governor, the Attorney General, and our
colleagues in the Assembly for working with us to lead the charge in
cracking down on prescription drug abuse so New Yorkers are better
protected."
Assembly Speaker Sheldon Silver said, "Prescription drug abuse has
become a pervasive problem in communities across the state. This
legislation will help to control prescription drug abuse by creating a
real-time online database enabling doctors and pharmacists to track
certain controlled substances. This initiative will ensure patients
receive the medication they need and deter those who seek to abuse them.
I applaud Governor Cuomo for his leadership on this issue and commend
Attorney General Schneiderman and my colleagues in the legislature for
supporting this important life saving measure."
Senator Andrew Lanza said, "This historic agreement will allow New
York to be at the forefront of the battle against the prescription drug
abuse epidemic, which has destroyed families and lives from one end of
the state to the other. The agreed upon legislation will allow doctors
and pharmacists to have the information they need to ensure that we turn
the tide on this deadly crisis. I thank the Governor, Attorney General
Schneiderman, Senator Skelos, the Speaker, Senator Hannon and
Assemblyman Cusick for working so long and so hard in this cooperative
effort."
Senator Kemp Hannon said, "Comprehensive action to address the misuse
of painkiller drugs in New York is needed. In the last documented year,
over 22 million prescriptions for painkilling drugs were written –
without refills – in a state with only 19 1/2 million people. The
cooperation and collaboration evidenced by this legislation marks the
beginning, not the conclusion of a concentrated effort to bring a
balance to these drugs. This bill reflects the Senate's work as
evidenced by our two roundtables and a report, addressing the number one
health crisis today."
Assembly Member Michael Cusick said, "I want to thank Governor Cuomo,
Attorney General Schneiderman, Speaker Silver and all of my colleagues
who worked together to craft this agreement. This is meaningful
legislation that provides an essential tool to allow for the responsible
dispensation of prescriptions by medical professionals and pharmacists.
It will protect access to critical medication for patients who truly
need it. But at the same time, appropriate controls will be implemented
to restrict access of abusers and ensure those who profit from the abuse
face the necessary consequences."
Illicit use of prescription medicine has become one of the nation’s
fastest-growing drug problem. According to the federal Centers for
Disease Control and Prevention (CDC), nearly 15,000 people die every
year of overdoses due to prescription painkillers. In 2010, 1 in 20
people in the United States over the age of 11 reported using
prescription painkillers for nonmedical reasons in the past year. During
the period 1999 through 2008, overdose death rates, sales, and
substance abuse treatment admissions related to prescription painkillers
all increased substantially. Sales of opioid painkillers quadrupled
between 1999 and 2010. Enough opioid painkillers were prescribed in 2010
to medicate every American adult with 5mg of hydrocodone every four
hours for a month. Moreover, an estimated 70 percent of people who abuse
prescription painkillers obtained them from friends or relatives who
originally received the medication from a prescription. The problem is
of particular concern with respect to young adults and teens.
Details of the legislation are as follows:
The Creation of a New and Updated Prescription Monitoring Program (I-STOP)
The legislation will require updating and modernization of Department
of Health (DOH)’s Prescription Monitoring program (PMP) Registry to
make it one of the best systems in the nation to monitor prescription
drug abuse and to help the medical community provide better care. The
new system will substantially decrease opportunities for “doctor
shoppers" to illegally obtain prescriptions from multiple
practitioners. The legislation requires enhancement and modernization of
DOH’s secure prescription monitoring program registry, which will
include information about dispensed controlled substances reported by
pharmacies on a “real time" basis, to effectively stop doctor
shopping and combat the circulation of illegally-obtained prescription
drugs.
The PMP Registry will be secure and easily accessible by
practitioners and pharmacists, allowing them to view their patients’
controlled substance history. In addition, this legislation strikes the
right balance by requiring health care practitioners to consult the PMP
Registry before prescribing or dispensing the controlled substances that
are most prone to abuse and diversion, while exempting practitioners
from consulting in specific situations in order to protect patient
access to needed medications. Moreover, pharmacists, for the first time,
will now be able to consult the PMP Registry before dispensing a
controlled substance.
Mandating Electronic Prescribing of Controlled Substances
The comprehensive package will make New York a national leader by
being one of the first states to move from paper prescriptions to a
system mandating the electronic prescribing (e-prescribing) for all
controlled substances with limited exceptions. E-prescribing is critical
to help to eliminate diversion that results from the alteration,
forgery, or theft of prescription paper.
In addition, electronic prescribing enhances patient care by
minimizing medication errors due to misinterpretations of handwriting on
written prescriptions. It is estimated that 20 percent of the
approximately 7,000 annual deaths caused by medication errors are
attributable to misinterpretations of written prescriptions. Moreover,
medication errors are estimated to cost the nation’s health care system
over $70 billion each year. In New York, adverse drug events due to
errors in written and oral prescriptions carry an annual cost to the
health care system of approximately $130 million.
E-prescribing will also improve the efficiency of practitioners and
pharmacies. Approximately 30 percent of prescriptions require
pharmacists to call physicians due to poor handwriting on prescription
forms. Additionally, e-prescribing is also more convenient for
consumers, who would otherwise need to either wait at the pharmacy for a
prescription to be filled, or make separate trips to drop off the
prescription form and then pick up the medication.
E-prescribing of controlled substances will ensure that controlled
substance transactions are transmitted in a secure, encrypted fashion to
their intended recipient.
Updating the Controlled Substance Schedules to Stop Abuse of Certain Drugs, While Protecting Patient Access
The legislation combats prescription drug abuse by removing
hydrocodone from Schedule III and placing it on Schedule II regardless
of formulation. Hydrocodone is among the most abused and diverted
prescription medications. In New York, last year, over 4.3 million
hydrocodone prescriptions were filled — the most in the state.
Nationally, eight percent of all high school seniors used hydrocodone
for non-medical purpose. In 2009 alone, there were over 86,000 emergency
room visits resulting from the non-medical use of hydrocodone.
Placing hydrocodone on Schedule II will control abuse by eliminating
automatic refills and, in general, by limiting the amount prescribed or
dispensed to a maximum 30-day supply. However, to protect legitimate
access for those patients who need these drugs, the bill will not alter a
practitioner’s ability under existing regulations to prescribe a supply
of up to 90 days if he, or she, indicates on the face of the
prescription that the patient has one of several enumerated conditions,
including chronic pain.
The legislation will also add another drug, tramadol, to Schedule IV.
Tramadol is a painkiller and is viewed as a drug of concern by the
DEA.
Improving Education and Awareness of Prescribers to Stem the Tide of Prescription Drug Abuse
According to the CDC, a significant percent of abused medications are
prescribed to the person that abuses them. This comprehensive
legislation recognizes the need for increased education amongst health
care providers about the potential for abuse of controlled substances,
and the proper balancing of pain management with abuse prevention.
The bill would expand the functions of the workgroup to be
established by the Department of Health under the existing Prescription
Pain Medication Awareness Program, so that the workgroup will be
responsible for making recommendations on: (1) continuing education for
practitioners and pharmacists on pain management issues; (2) protecting
and promoting access by patients with a legitimate need for controlled
substances; (3) the implementation of the I-STOP provisions; and (4)
inclusion of additional controlled substances in the consultation
requirements of I-STOP. To carry out these functions, the Commissioner
of Health will include additional stakeholders, including but not
limited to consumer advocacy organizations, health care practitioners
and providers, pharmacists and pharmacies, and representatives of law
enforcement agencies.
Creating a Safe Disposal Program to Safely Dispose of Prescription Drugs
Recognizing that more than 70 percent of the abused prescription
medications are obtained from friends or relatives, this legislation
requires DOH to institute a program for the safe disposal of unused
controlled substances by consumers. Through the program, DOH will work
with local police departments to establish secure disposal sites for
controlled substances on the premises of police stations. At these sites
individuals can voluntarily surrender unwanted and unused controlled
substances.
Under present law, individuals can only safely dispose of controlled
substances during an approved take back event or, various methods of
self-disposal that are either burdensome or harmful to the environment.
Moreover, current federal regulations prohibit patients from returning
unused controlled substances to pharmacists and doctors. This program
will help alleviate this problem by providing a continual safe disposal
option to New Yorkers.
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