Looking to make a dent in what has become an epidemic of prescription drug abuse in New York, state officials Tuesday agreed on a sweeping deal to require physicians and pharmacists to check a "real-time" database before dispensing certain drugs, such as addictive painkillers.
The deal comes after high-profile suicides in Buffalo of people addicted to prescription opiates and the murder of four people at a drug robbery last year at a Long Island pharmacy.
"This is going to give New York the best-in-the-nation system for tracking prescription drugs," State Attorney General Eric Schneiderman said in an interview Tuesday.
"This is going to enable law enforcement to get a handle on the fastest growing drug problem in New York and America," said Schneiderman, who scored his biggest legislative victory since becoming attorney general with Tuesday's prescription drug deal, an initiative he pushed for a year.
"I'm happy, but it's a bittersweet kind of feeling," said Avi Israel, a Buffalo resident whose son, Michael, killed himself a year ago Tuesday after an addiction battle with prescription painkillers. "I'm happy that we have a deal, but I'm also sad because I don't have my son. All of this could have been avoided had we done something about it a couple years ago."
"But I'm happy that future generations and other parents will not have to go through what my wife and I and other parents have been through," Israel said.
The measure, opposed by some doctors who worry the system will be unwieldy and take away from patient time, is meant to target doctor- and pharmacy-shopping by addicts and those who illegally trade in prescription narcotics.
The agreement also will make New York one of the first states to require electronic, instead of paper, prescriptions for certain drugs. That system will kick in within two years. Advocates say it will eliminate the growing problem of fraudulent paper prescriptions, especially for prescription painkillers.
The Buffalo News last year produced a special report, "Rx for Danger," which brought attention to the growing prescription drug problem in the state. The series found that prescription opioids have become more popular among drug abusers than cocaine and that Western New York is a hot spot for some of the most abused opioids -- fentanyl, hydrocodone and oxycodone.
The real-time reporting requirement -- in which physicians and pharmacists would have to check the prescription records of a patient before dispensing a new prescription -- would be based on an Oklahoma model.
Precisely what is real time -- whether immediate or if it would be delayed by some number of hours -- will be left up to Health Department regulations and the technology that can be put in place to run the system. Schneiderman said the Health Department will be working out those details, but he said the system should be able to report to doctors and pharmacists within seconds of changes to a patient's drug database.
The state currently has a prescription drug database, but doctors use it on a voluntary basis, and it runs up to 45 days behind real time. And while pharmacists enter information that feeds into that database, they cannot check it to see if a consumer is shopping around to get multiple narcotic prescriptions in a short time.
The final sticking point for a week has been whether the new tracking system also will cover certain kinds of drugs that are considered less addictive -- such as cough syrup with codeine. The final deal permits some new enforcement provisions for such drugs, and prescribers can voluntarily check such so-called Schedule V drugs. Stakeholders in a future working group can recommend tightening such drug monitoring.
The fight was waged largely between family members of drug abuse victims and some in the state's medical community. Doctors warned the system could be unwieldy, will take away time physicians have to spend with patients and will dissuade some doctors from prescribing needed medications out of fear of liability issues.
The lobbying group representing doctors did not immediately respond to comment.
"This was driven from the perspective of families that have lost loved ones across New York but in particular in Western New York, where so many families have lost sons and daughters," said Sen. Timothy Kennedy, a Buffalo Democrat who worked with the Israel and other families to push the measure.
The final agreement -- the actual legislation has not yet been made public -- also calls for a new program to better educate physicians on the worsening problem of prescription drug addictions.
Physicians and pharmacists will have to check a Department of Health database that will hold the prescription records of patients who have gotten certain kinds of narcotics, such as painkillers. Advocates insisted the program will include protections for patient confidentiality.
The deal calls for additional safeguards, such as banning automatic refills and only allowing up to a 30-day supply on certain kinds of especially addictive drugs, such as hydrocodone, and a public awareness program on prescription narcotic addiction problems.
Schneiderman said it also includes a new drug-disposal program to encourage New Yorkers to get rid of prescription drugs in their medicine cabinets. He said most young people get drugs through their parents' medicine cabinet.
The agreement also includes some protections for dispensing certain drugs on an emergency basis for 90 days if a patient suffers from certain conditions, including long-term pain.
The federal government reported that in 2010 one in 20 people in the nation over age 11 used prescription painkillers for nonmedical reasons. Officials said there were enough opioid painkillers prescribed in 2010 to medicate every adult at a rate of once every four hours.
Suzanne Crotty, a Colden resident who helped launch the prescription drug effort at the Capitol after her son, Zach, died in 2009 from a prescription drug overdose, said, "I know this is not going to be the final answer because addiction is a disease and people are always going to try to get these drugs; but it will help if we can get doctors to stop prescribing so many of these drugs and if they have the tools to know that another doctor has already prescribed a drug."