Monday, September 23, 2013

NYS I-STOP Prescription Monitoring Program

In 2012, Governor Andrew Cuomo signed the I-STOP or "Internet System for Tracking Over-Prescribing" act into law and it is now mandatory for 2013.  The law requires all prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing and Schedule II, III and IV controlled substances.  Each prescriber must have an individual Health Commerce System Account (HCS) to gain access to the PMP registry.   This may lead to more electronic prescribing for controlled substances down the road.

In the New York State Office of the Attorney General's proposal, they cite:

"Prescription drug diversion involves channeling legitimately produced controlled substances from their lawful purpose into illicit drug traffic. Abuse of diverted drugs comprises the nation’s fastest growing drug problem, and in recent years has reached epidemic proportions. It affects every sector of society, straining our healthcare and criminal justice systems, and endangering the future of our younger generations.


Painkiller overdoses nationwide killed nearly 15,000 people in 2008. In New York, the number of prescriptions for all narcotic painkillers has increased from 16.6 million in 2007 to nearly 22.5 million in 2010 - prescriptions for hydrocodone have increased 16.7 percent, while those for oxycodone have increased an astonishing 82 percent. In New York City, the rate of prescription pain medication misuse among those age 12 or older increased by 40 percent from 2002 to 2009, with nearly 900,000 oxycodone prescriptions and more than 825,000 hydrocodone prescriptions filled in 2009. The roots of the problem are two-fold. First, a lack of education and communication between practitioners significantly increases the likelihood of over-prescribing and dangerous drug interaction. Second, access to an ever-increasing supply of prescription narcotics, through legal or illegal means, has grown four-fold in the past decade.

Virtually all observers of prescription drug diversion agree that expanding the use of Prescription Monitoring Programs (PMPs), and enhancing the quality and availability of the data they collect, are essential to the solution. The federal Governmental Accountability Office (GAO), the Centers for Disease Control and Prevention (CDC), the insurance industry, the White House, and independent researchers all point to such an expansion as a key part of the solution to prescription drug fraud, abuse and diversion.

While New York’s PMP collects critical data on prescription drugs dispensed by pharmacists, the current system is outdated with regard to how and when data is collected, who has access to it, and how it is used.

I-STOP will vastly enhance the effectiveness of the present system. Its goal is to enable doctors and pharmacists to provide prescription pain medications, and other controlled substances, to patients who truly need them. At the same time, it will arm them with the necessary data to detect potentially dangerous drug interactions, identify patterns of abuse by patients, doctors and pharmacists, help those who suffer from crippling addictions and prevent potential addiction before it starts."   

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