The Internet System For Tracking Over-Prescribing (I-STOP) Act

By   /   April 15, 2013 

 

The Internet System For Tracking Over-Prescribing (I-STOP) Act

Amanda R. Lamberson*

 

“Now, New York will be a national leader in protecting the public from the devastating consequences of prescription drug abuse.”1

 

I. Introduction

On June 11, 2012, the New York State Legislature unanimously passed the Internet System for Tracking Over-Prescribing (I-STOP) Act.2  I-STOP will create an online “real-time” system for practitioners and pharmacists to report and track controlled substances.3  New York will break ground by requiring that a practitioner “consult a database of a patient’s prescription history before prescribing a schedule II, III, or IV controlled substance.”4  Furthermore, pharmacists will engage in a more advanced method of reporting.5

The primary purpose of I-STOP is to take an aggressive approach to the growing prescription drug abuse epidemic in New York by regulating the root of the problem: prescribing and dispensing controlled substances.6  This article will explore I-STOP as a necessary step in ending the war on drugs.  Section II will provide a glimpse into the current prescription drug abuse problem in New York, and Section III will examine the I-STOP legislation and how it will transform the way practitioners and pharmacists prescribe and dispense controlled substances.

 

II.  The Prescription Drug Abuse Epidemic

On June 4, 2011, twenty-year-old Michael D. Israel committed suicide after battling an addiction to prescription drugs.7  On June 19, 2011, four individuals lost their lives during the Medford pharmacy shootings.8  “All [four] were slain by David Laffer, who wanted pain pills for himself and his wife, Melinda Brady.”9  On December 31, 2011, an off-duty Alcohol Tobacco Firearms and Explosives agent lost his life when he intervened during a robbery involving prescription drugs at a pharmacy in Seaford, New York.10  These three acts of violence share one common theme: “The abuse of prescription drugs is a statewide problem.”11

In support of I-STOP, New York Attorney General Eric T. Schneiderman released a report that documented the growth of prescription drug abuse in New York by the numbers.12  According to the report, “prescriptions for all narcotic painkillers has increased from 16.6 million in 2007 to nearly 22.5 million in 2010.”13  Most striking is the statistic that prescriptions for oxycodone have increased 82 percent.14  Furthermore, New York has been ranked “[eleventh] in the nation for admissions to chemical dependence programs for abuse of opioids other than heroin.”15  As a result, increased detox needs have placed a strain on hospitals that attempt to meet the demand.16  These acts of violence and staggering statistics call for change and I-STOP is a necessary step in the right direction.

 

III.  The Internet System for Tracking Over-Prescribing (I-STOP) Act

The complexity of this epidemic and the various problems associated with prescription drugs support the notion that I-STOP is an integral state effort.17  Although this legislation will take time to implement and perfect,18 practitioners will no longer find it voluntary to check a patient’s prescription history on an electronic system before prescribing a controlled substance.19  Furthermore, pharmacists will have access to this information online, which the current system does not allow.20  As a result, appropriate prescribing will be possible without the high risk of abuse.

I-STOP will also mandate electronic prescriptions for controlled substances, re-schedule certain drugs, enhance continuing education for practitioners and pharmacists, and develop safe disposal of unwanted prescription drugs.21  Most significant, however, is the “prescription monitoring program registry,” which will become an entirely new section of the New York Public Health Law.22  As part of the registry, “patient-specific information” will be available to practitioners and pharmacists including, but not limited to, the patient’s name and address, the date on which the prescription was issued and dispensed, and the prescriber’s information.23  Furthermore, the system will be “easily accessible by practitioners and pharmacists.”24

Most importantly, practitioners must consult the registry before prescribing or dispensing schedule II, III, or IV controlled substances.25  There are, however, some instances where this duty will not apply.26  On the other hand, pharmacists may consult the registry to view the prescription history of an individual before dispensing a controlled substance.27  Although this particular action is not mandatory, pharmacists must file a “real time” report to the registry when such prescriptions are dispensed.28  Although real time reporting is not a particularly clear concept, legislative intent and the purpose of I-STOP suggest that filling a prescription and reporting that information must be done simultaneously.29

 

IV.  Conclusion

In sum, New York is currently facing a prescription drug abuse epidemic.  However, it is not the only state facing the various problems associated with prescription drugs.  One stunning statistic states, “Americans constitute only 4 percent of the world’s population [and] . . . now consume 80 percent of the global supply of opioids, and 99 percent of the global supply of hydrocodone.”30  Therefore, the New York Legislature has taken a necessary step in the right direction, made New York a national leader by unanimously passing I-STOP, and developing a system to report, monitor, and track when controlled substances are prescribed and dispensed.

 


 

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Footnotes:

  1. Press Release, A.G. Eric T. Schneiderman, A.G. Schneiderman’s Landmark I-STOP Bill To Curb Rx Drug Abuse Unanimously Passes NYS Legislature (June 11, 2012), available at http://www.ag.ny.gov/press-release/ag-schneidermans-landmark-i-stop-bill-curb-rx-drug-abuse-unanimously-passes-nys.
  2. Id. (“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.”).
  3. 2012 N.Y. Laws Ch. 447 [hereinafter “Ch. 447”] (“The commissioner shall, in accordance with the provisions of this section, establish and maintain an electronic system for collecting, monitoring and reporting information . . . .”).
  4. Press Release, A.G. Eric T. Schneiderman, supra note 1.
  5. Id. The “real-time” reporting requirement is described in Section III.
  6. See, e.g., Matthew Chayes & Robert E. Kessler, A Mom Hails New Rx Tracking Law, Newsday, June 28, 2012, at A04, available at 2012 WLNR 13444086 (“[T]he law aims to crack down on doctor shopping, in which addicts and drug dealers travel from doctor to doctor, and druggist to druggist to obtain numerous pills beyond what they should be prescribed.”).
  7. See N.Y. State Senate, Senate Passes Legislation to Reduce Prescription Drug Abuse (June 11, 2012), http://www.nysenate.gov/press-release/senate-passes-legislation-reduce-prescription-drug-abuse.
  8. See Tania Lopez, Families Mark Day In Their Own Ways, Newsday, June 20, 2012, at A14, available at 2012 WLNR 12860105.
  9. Id.
  10. See Will Van Sant et al., LI’s Alarming Addiction Crisis, Newsday, June 17, 2012, at A02, available at 2012 WLNR 12643676.
  11. N.Y. State Senate, supra note 6.
  12. N.Y.S. Office of the Attorney General, A Proposal Addressing New York’s Prescription Drug Abuse and Drug Diversion Epidemic [hereinafter “A.G. Report”] (Jan. 10, 2012), available at http://www.ag.ny.gov/sites/default/files/press-releases/2012/ISTOP%20REPORT%20FINAL%201.10.12.pdf.
  13. Id. at 1.
  14. Id.
  15. Id. at 4 (citation omitted).
  16. See Ridgely Ochs, Detox Needs Rising, Newsday, Jan. 16, 2012, at A10, available at 2012 WLNR 992625 (“Two of the four hospitals on Long Island that have designated beds for drug detox or rehabilitation are asking the state to expand their number as a result of increasing drug abuse – including of prescription painkillers.”).
  17. See Ch. 447 (“The legislature finds that prescription drugs, particularly controlled substances, are increasingly subject to criminal diversion and abuse, which can result in addiction, adverse drug events, accidental death due to overdose, violent or self-injurious behavior, family conflicts, and increased costs to businesses and the health care system.”).
  18. See Matthew Chayes & Robert E. Kessler, supra note 5 (“12 months to implement, and until nearly 2015 for the electronic prescription system to be fully online.”).
  19. See Toughen Drug Regulation, Buffalo News, Feb. 9, 2012, at A6, available at 2012 WLNR 2865990 (describing the flaws in the current system).
  20. Id.
  21. I-STOP is labeled Part A through Part E.  See Ch. 447; see also Press Release, A.G. Eric T. Schneiderman, supra note 1 (describing the highlights of this new legislation).
  22. See Ch. 447 (describing § 3343-a).
  23. Id.
  24. Id.
  25. See Ch. 447 (describing the duty to consult); see also N.Y. Public Health Law § 3306 (2012) (listing the controlled substances that belong to each schedule).
  26. See, e.g., Ch. 447 (“[A] practitioner prescribing a controlled substance in the emergency department of a general hospital, provided that the quantity of controlled substance prescribed does not exceed a five day supply . . . .”).
  27. See Ch. 447 (describing the authority to consult).
  28. See Ch. 447 (amending N.Y. Public Health Law § 3333).
  29. See, e.g., Ch. 447 (“Therefore, the legislature finds it appropriate and necessary to establish a prescription monitoring program registry that is designed to utilize real time data . . . .”).
  30. A.G. Report, supra note 11, at 3 (citation omitted).