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Albany moved quickly on drug-tracking bill; State is on verge of 'real-time' system

A teenager addicted to prescription painkillers dies of an overdose just outside of Buffalo.

A district attorney warns that prescription opiates are responsible for several deaths on Staten Island.

Four people are killed during a robbery at a Long Island pharmacy -- the robber stealing 11,000 powerful prescription pills.

Another young man in Buffalo addicted to opiates commits suicide.

A federal agent is slain on Long Island during yet another pharmacy robbery.

From tragedy upon tragedy comes a new state law.

In a city known more for stalemate and political intransigence than for getting things done, Albany's political leaders -- pressured by grieving parents from one end of New York to another -- ignored the well-financed interest groups and their own political pettiness to agree on a plan supporters hope will go a long way toward ending all the death.

And they did it, by Albany measures, in almost record time.

Lawmakers last week reached agreement on a measure spearheaded by Attorney General Eric T. Schneiderman and finalized by Gov. Andrew M. Cuomo to bring "real-time" electronic monitoring of prescription drugs to New York. The legislation may be passed as soon as Monday.

By requiring that prescriptions for certain drugs be regularly logged into an electronic database and made available to doctors and pharmacists, supporters believe the law will help stop "doctor shopping" as well as the overprescribing of medications, some of which are dangerous when combined.

It's hard to say exactly when Albany became aware of the problem, but one date that stands out for Western New Yorkers is Oct. 26, 2009.

That's when Zachary T. Crotty, of Colden, died at age 19.

It was only after their son's death that Suzanne and Mark Crotty learned the full extent of Zach's prescription drug addiction. And when they did, they struggled to understand how the teenager was able to get all those medications. He bought some on the streets, including the fatal dose of methadone he took the day he died. But other medications -- anti-depressants, anti-anxiety drugs, anti-seizure medication -- came from Zach's doctors. And some of the drugs, the Crottys learned, should not have been prescribed, given another medication Zach was taking to help him overcome his opiate addiction.

"Physicians have to realize when they write prescriptions for people with addictions, drug-drug interactions are something you have to be very careful of," said Dr. Richard D. Blondell, an addiction specialist who was working with Zach. "It's upsetting that some of my colleagues contribute to the problems, a lot of times unknowingly."

When talking to Suzanne Crotty after Zach's death, Blondell suggested New York would benefit from a real-time electronic monitoring system.

New York had electronic monitoring, but it wasn't in real time, and it was clunky to use. In fact, when Blondell put Zach's name in the computer, nothing came up.

In April 2010, Suzanne Crotty and Blondell met with then-Assemblyman Jack F. Quinn III, R-Hamburg, who agreed to sponsor a bill requiring prescriptions be logged into an electronic system in real time, meaning soon after the prescriptions are filled. Quinn had a draft bill started in October 2010.

Meanwhile, oxycodone, one of the strongest of the prescription opioid painkillers, hit the illegal street market big time on Staten Island, the smallest of New York City's five boroughs.

"On Staten Island, it was as huge an issue as it was in Erie County," said Assemblyman Michael Cusick, a Staten Island Democrat.

"You couldn't go to a soccer game without someone coming up to me and talking about this," said State Sen. Andrew Lanza, R-Staten Island.

The island borough had become an epicenter of prescription drug addictions, with one person dying, on average, every 13 days, lawmakers said.

By the fall of 2010, Cusick and Lanza were holding round-table talks as they prepared to introduce legislation to address the problem.

>Roots of the legislation

Such upstate-downstate bipartisan support isn't routine in Albany, but even geographic and political balance doesn't guarantee bills will be passed in the politically charged state Capitol. Not even, as is the case this year, when all legislators are up for re-election.

Enter Eric Schneiderman.

As a Democratic state senator from Manhattan, Schneiderman approached Republican Lanza in 2010 about working together on the issue of prescription drug abuse, Lanza said.

The following year, when Schneiderman became attorney general, the topic quickly became one of his top legislative priorities.

The "epidemic" of prescription drug abuse was discussed at a meeting of the National Association of Attorneys General that Schneiderman attended in March 2011. That same month, Schneiderman read "Rx for Danger," a series published by The Buffalo News detailing the explosion of illegal prescription drugs across the state, and particularly in Western New York.

"We began, in my office, speaking to people with expertise, and getting in touch with people in other states," the attorney general said.

In June 2011, Schneiderman came out with a broader plan for addressing the issue than what was in the Quinn draft or the original Cusick-Lanza bill.

That same month, a gunman walked into a family-owned Long Island pharmacy at about 10:20 one morning, shot and killed two employees and two customers, then stole 11,000 hydrocodone pills.

Also in June 2011, Michael David Israel, 20, went into a bedroom in his North Buffalo home and shot himself. Michael's father, Avi, rushed into the bedroom after hearing the shot. Michael died in his father's arms.

Michael had suffered for years with Crohn's, a painful autoimmune disease, and more recently was being treated for depression associated with his disease. Several different doctors had prescribed various drugs, leaving Michael addicted to opiates, particularly hydrocodone. The family blames the drugs for Michael's death.

"Drugs were taking over his life," his father said. "He was taking a pill to wake up, a pill with his meals, a pill for pain and a pill for sleeping. He had a cocktail of drugs inside of him, and I don't think one doctor knew what the others were prescribing."

>Intense negotiations

Quinn, the Hamburg assemblyman, ran for State Senate in November 2010 and lost. He was gone from the Legislature at the end of December. When the original Cusick-Lanza bills were introduced in January 2011, some Western New York lawmakers involved with Quinn's draft bill moved their support to the Cusick-Lanza bill. Schneiderman also began working with Cusick and Lanza, who agreed to substitute the attorney general's bill for their own.

But there was much work to do.

What Lanza initially saw as a simple mandate -- requiring doctors and pharmacists to check a patient's drug history -- grew far more complex with an assortment of issues: patient confidentiality, a doctor's scope of practice, ethical concerns, liability matters, technological constraints and a concern that some doctors might avoid writing painkiller prescriptions to patients who legitimately needed them.

Negotiators described daily sessions over the past month and major push-backs from the politically potent physician and pharmaceutical industry lobbies.

"People don't like change," Lanza said of the industry concerns.

The final element to the deal was Gov. Andrew M. Cuomo, who brought the political weight of his office to the negotiating table. In the end, the governor, whose administration's Health Department will have to carry out the nitty-gritty work of the real-time reporting system, extracted its own demands in talks that began involving his office last fall.

While the backdoor negotiations were occurring, there were more deaths.

An off-duty federal agent was shot and killed Dec. 31, 2011, in the mayhem that occurred after a thief stole cash and oxycodone painkillers from a Long Island pharmacy. The agent was in the pharmacy at the time picking up cancer medication for his father.

Grieving Long Island families met with lawmakers. So did grieving Western New York families, particularly Avi and Julie Israel, who were determined to help prevent more prescription-drug-related deaths like that of their son Michael.

"I have never seen a group of individuals more committed to making sure other families don't go through what they went through," said State Sen. George D. Maziarz, R-Newfane, who was among the local lawmakers who met with the Israels and worked to solidify support for the prescription drug bill.

"There were many times," Avi Israel said, "where we had to pass tissues around to legislators and their aides. These are horrific stories about people losing kids unnecessarily."

Being a parent and listening to the stories of the Israels and the others, Cusick said, "provided a sense of urgency that I would hope would be there if not for the fact that I was a parent, but I know was certainly there because I am a father."

"As a human being, your first reaction is to do something. With this case and with this legislation, there were just so many stories, and you had so many families who wanted us to do something," added Cusick.

In the end, timing, the families' advocacy, statistics of a growing problem and political will provided the muscle to get an agreement on real-time prescription monitoring.

"It was a textbook example in how a bill becomes law," Cusick said.

Still to be determined, however, is how well the system New York is developing will be implemented.

"As this rolls out, will it be a useful tool or another burden?" said Blondell, who was among the early advocates of real-time drug monitoring in New York.

Also to be determined is how effective the reforms of one state can be, when other states have more lax rules.

"Passing this bill is just the beginning," Avi Israel said. "We are going to take the New York bill and use it as a national model. We are going to move it across the country."

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