New York State Enacts New Law to Prevent Drug Diversion
New York has become one of the first states in the union to pass legislation to address prescription drug abuse. Called the I-STOP Act, the legislation is designed to curb prescription drug diversion and abuse while also making it easier for legitimate pain patients to fill their prescriptions.
Effective March 27, 2015, physicians “are no longer allowed to use paper prescriptions,” noted a press release from the state.1 “They may send all prescriptions electronically.” As noted, this is a major shift in how medications will be prescribed—“and this law is the first of its kind.”
Additional changes in the new law include enacting a “real time” prescription monitoring registry to provide timely and enhanced information to clinicians and pharmacists; improving safeguards for the distribution of specific prescription drugs that are prone to abuse; developing medical education courses and other public awareness measures regarding pain management and prescription drugs; and requiring the Department of Health (DOH) to establish a safe disposal program for unused medications.
Upon the signing of the law, New York State Attorney General Eric Schneiderman said, “I-STOP will be a national model for smart, coordinated communication between health care providers and law enforcement to better serve patients, stop prescription drug trafficking, and provide treatment to those who need help. This accomplishment is a testament to the hard work and tenacity of the families who turned their loss into action that will help people in our state for years to come.”
E-Prescribing of Controlled Substances
The new law will make New York 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, noted the press release. E-prescribing is a critical component of the new law. By requiring e-prescribing, the state hopes to eliminate diversion that results from the alteration, forgery, or theft of paper prescriptions. E-prescribing should also help reduce medications errors cause by misread paper prescriptions. “E-prescribing of controlled substances will ensure that controlled substance transactions are transmitted in a secure, encrypted fashion to their intended recipient,” noted the state.
Prescription Monitoring Programs
A growing number of states have implemented Prescription Monitoring Programs (PMP). New York State is currently updating their system “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.
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 in New York State will now be able to consult the PMP Registry before dispensing a controlled substance.
Protecting Patient Access
Following the Drug Enforcement Agency’s reclassification of hydrocodone from Schedule III to Schedule II, New York State hopes to further control abuse of the medication 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 new law will also add another drug, tramadol, to Schedule IV.
Improving Education and Awareness
According to the Centers for Disease Control and Prevention (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 expands the functions the DOH workgroup, so that the workgroup will be responsible for making recommendations on:
- Continuing education for practitioners and pharmacists on pain management issues
- Protecting and promoting access by patients with a legitimate need for controlled substances
- Implementation of the I-STOP provisions
- Inclusion of additional controlled substances in the consultation requirements of I-STOP.
To carry out these functions, the Commissioner of Health will include in the workgroup consumer advocacy organizations, health care practitioners and providers, pharmacists and pharmacies, and representatives of law enforcement agencies.
Safe Disposal of Prescription Drugs
Recognizing that more than 70% of the abused prescription medications are obtained from friends or relatives, the new 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. Individuals can dispose of unwanted and unused medications at these sites. Under previous law, individuals could only safely dispose of controlled substances during an approved Take Back Events sponsored by the DEA.