State's new prescription pain pill system snags apparent doctor shoppers

OxyContin pills are shown at a pharmacy in OxyContin pills are shown at a pharmacy in Montpelier, Vt. (Feb. 19, 2013) Photo Credit: AP

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In its first three days of use, New York State's new online system for tracking prescription pill abuse discovered at least 200 instances of apparent doctor shopping, when patients visit a number of doctors in search of prescriptions for pain pills.

Statewide, 16,352 health care providers and pharmacists used the updated online system to track prescription pill abuse from Tuesday, when it came online, through Thursday, resulting in dozens of doctors identifying patients suspected of abusing pain pills, authorities said.

Users statewide of the system, known as I-STOP -- Internet System for Tracking Over-Prescribing -- conducted 162,719 searches for 146,156 patients over those three days, according to the state Department of Health, which oversees the program.

Several officials involved in the program said I-STOP users had discovered at least 200 apparent instances of patients improperly obtaining or trying to obtain pain pills from multiple doctors in a short period of time, a practice known as doctor shopping.

The state on Tuesday also began requiring real-time reporting to the I-STOP system by pharmacists when prescriptions for opioids are filled.

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Taking the leadNew York is the first state to require doctors to consult a patient's prescription history before prescribing opioid pain pills, which is meant to stop both pain pill overprescribing and also the practice of doctor shopping.

The importance of tracking substance abusers was heightened after Newsday disclosed that convicted killer David Laffer and his wife, Melinda Brady, obtained thousands of pain pills from physicians in the months leading up to June 19, 2011, when Laffer fatally shot four people in a Medford pharmacy and stole thousands of additional pain pills.

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Another galvanizing event was the accidental fatal shooting of federal Alcohol, Tobacco, Firearms and Explosives agent John Capano on Dec. 31, 2011, by a retired Nassau County police officer. Capano was struggling with a suspect who had robbed a Seaford pharmacy of painkillers when he was shot.

Dr. Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence, said the implementation of mandatory checks marked an important turning point in the state's handling of the opioid epidemic.

"For those of us on the front lines of addiction . . . [the implementation] gives us hope that we can finally stop the flow of opiates into our communities and turn our full attention to getting those who are struggling with addiction into treatment," Reynolds said.

The first phase of I-STOP took effect in November 2012, when I-STOP patient queries were not mandatory. Officials said then that a fraction of New York's doctors monitored the state's previous database, called the Controlled Substance Information system. From January through November 2011, officials said, 2,216 of about 80,000 health care providers statewide who could prescribe painkillers and other drugs used that system.

Providers and health care professionals hailed the new system that requires monitoring. And officials said use of the system would gradually increase in the coming months to include more health care providers statewide.

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"It's been easy to use and very helpful," said Dr. Thomas Jan, a pain management and addiction specialist in Massapequa, who learned through I-STOP that a longtime patient had been doctor shopping. "It's pushed me to check every single patient, whether there's a problem or not."

Seeing resultsJordan Fogel, supervising pharmacist and owner of Linden Care pharmacy in Syosset, said the new I-STOP requirements are already helping to fight Long Island's pain pill abuse epidemic and imparting doctors and pharmacists with knowledge they never had access to before.

"Three doctors called me today who discharged patients after they learned [the patients] were doctor shopping because of I-STOP, so I'd say the system is working out pretty well so far," Fogel said. "It's a tremendous help because it's real time information."

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Dr. Brian Durkin, director of the Center for Pain Management at Stony Brook University Medical Center, said he was not a frequent user of the non-mandatory system because it was not user-friendly.

"I'm relatively happy with this new system," Durkin said. "We already caught one patient who had been going to four different doctors."

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More changes to comeThe I-STOP system, championed by New York Attorney General Eric T. Schneiderman, was signed into law by Gov. Andrew M. Cuomo in August 2012. The law included provisions to overhaul the way prescription drugs are distributed and tracked in New York State, including requiring all prescriptions to be electronically transmitted to pharmacies by March 2015 and changing the classification of the heavily abused pain medication hydrocodone, making it harder to obtain.

The new reporting requirement led to some problems during its first days of operation. Several local health care professionals said they were unable to create electronic user accounts needed to make I-STOP queries due to a backlog of applicants.

"A large late surge of practitioners are now submitting requests [for the accounts]," the state Health Department said in a note posted on its website to I-STOP users. "Although the Department of Health is working diligently to process all requests, this significant influx has resulted in a delay in processing accounts."

Locally, the number of narcotics prescriptions written for Long Island residents fell 9 percent in 2012 -- nearly three times the statewide decrease -- and state officials said they expect a further decrease because of the new I-STOP requirements.

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