ALBANY - The governor and legislative leaders reached a deal Tuesday to dramatically overhaul the way prescription narcotics are tracked in New York, in response to a rash of pharmacy robberies, prescription thefts and drug-related deaths.

The breakthrough agreement, which would change how New York monitors opioids such as hydrocodone and oxycodone, was announced by Gov. Andrew M. Cuomo, Senate Majority Leader Dean Skelos (R-Rockville Centre) and Assembly Speaker Sheldon Silver (D-Manhattan). Rank-and-file legislators still have to pass bills to approve the changes before they adjourn June 21.

The deal requires "real-time" tracking when doctors write prescriptions for controlled substances and when pharmacists fill those scripts. It would also mandate -- for the first time -- that physicians participate in the tracking system. Their participation now is voluntary.

And it would make New York one of the first states to move to an all-electronic prescription system for controlled substances.

The mandates mark a significant break from New York's current system, which critics such as Attorney General Eric Schneiderman have said is riddled with loopholes that allowed addicts and others to go from physician to physician to amass powerful narcotics to use or sell.

For instance, the current state database of prescriptions for controlled substances is updated roughly every 45 days and pharmacists have no access to it. The new system -- lawmakers couldn't immediately say when it would go online -- would be updated at least every 24 hours at the start, with the goal of shortening the gap as it is developed. It would be managed by the state Health Department.

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"No state is going to have anything like New York," Schneiderman said.

Cuomo said it would make New York a "national leader" in curbing prescription drug abuse, a problem that has skyrocketed in the last decade. "This landmark agreement will help put a stop to the growing number of fatalities resulting from overdoses on prescription drugs," he said in a statement.

The negotiations came together just two weeks before the one-year anniversary of the Medford pharmacy murders in which David Laffer, now serving a life sentence, shot four people to death and stole hydrocodone.

It also came as the number of prescriptions written for narcotics has exploded. A Schneiderman report earlier this year found that prescriptions for oxycodone have skyrocketed "an astonishing 82 percent" across New York from 2007 to 2010.

Statewide, the number of prescriptions for all narcotic painkillers grew 36 percent, from 16.6 million to 22.5 million, over the same period.

Sen. Kemp Hannon (R-Garden City) noted that the 22.5 million prescriptions occurred "in a state with only 19.5 million people." Hannon, chairman of the Senate Health Committee, said the new system will "prevent the amassing of multiple prescriptions" but warned it could "shift the problem elsewhere."

The push for a "real time" tracking system drew strong opposition from the Medical Society of New York State, the physicians' lobbying group, who said it would add to an already heavy administrative burden.

Robert Hughes, president of the medical society, said at first glance the agreement "sounds like a nice, moderate approach." He agreed the current database was ineffective but noted that lawmakers produced a news release about the agreement, not a printed bill with specific details.

"The statement looks great. It's apple pie," Hughes said. "But the devil's in the details."

He said doctors would still prefer a voluntary system, but that they approve of the idea of pharmacists' access and electronic prescriptions.

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Activists hailed the deal.

"While this bill alone won't solve New York's prescription pill crisis, it will dramatically reduce prescription pill misuse and diversion, while simultaneously ensuring that those with legitimate medical needs have access to medications that will preserve and enhance their quality of life," said Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence.


What the deal would do


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Among the provisions of the agreement:

A "real time" prescription monitoring registry to provide timely and enhanced information to practitioners and pharmacists.

Requiring the state to move from paper prescriptions to electronic prescribing for all controlled substances (with limited exceptions).

Improving safeguards for the distribution of specific prescription drugs, including hydrocodone, to eliminate automatic refills.

Requiring the state Department of Health to establish a safe disposal program for unused medications.