Gov. Andrew M. Cuomo should veto a set of bills that would weaken the landmark I-STOP law that makes it difficult for people addicted to painkillers to obtain multiple prescriptions, local supporters of I-STOP stated in a letter to the governor.
“We were recently notified of proposed changes to I-STOP which would shockingly create opportunity for proliferation of pills as well as opening a window for inappropriate prescribing practices,” the letter from the Save the Michaels of the World Foundation stated.
The bills, approved by the State Legislature and awaiting the governor’s approval, would allow for a permanent waiver on prescriptions given by doctors over the phone for their patients in nursing homes. Doctors also would be allowed to make a notation at a later time in the patient’s chart that the prescription was issued.
Avi Israel, founder of Save the Michaels, said these provisions, if signed into law, mark the beginning of loosening the controls put in place with I-STOP, which in 2013 created a real-time electronic registry for doctors and pharmacists to check whether someone had more than one prescription for highly addictive opioid painkillers.
That was a big issue because so-called doctor shopping allowed for the misuse of these medications with drug dealers often obtaining the legally prescribed pills and then selling them to their customers. I-STOP provided the medical community with a tool to stop that practice.
Assemblyman Richard N. Gottfried, D-Manhattan, who sponsored the measures in the Assembly, says that the waiver aims to maintain a long-standing practice of allowing doctors to call in prescriptions because they are not always on duty in the nursing homes.
The waiver, according to Gottfried and other proponents of the bills, has to do with complying with a change in the law requiring all prescriptions to be filed electronically and addresses the fact that staff nurses call doctors at all hours when a patient is in need of prescription medication. Gottfried also said the waiver does not apply to prescriptions for opioids.
“The Department of Health waiver is written in a way that gives a mis-impression. But the DOH waiver ... does not apply to controlled substances, period. The term ‘I-STOP’ refers to the registry for controlled substance prescriptions. That’s what parents and other advocates fought for. The I-STOP requirements for checking the registry apply before a controlled substance is dispensed by a pharmacist whether a prescription is done electronically or not,” Gottfried said.
The other bill on making a notation in a medical chart, he said, is designed to make it easier to keep records of non-electronic prescriptions and does not impact the I-STOP system.
A spokesman for State Sen. J. Kemp Hannon, R-Garden City, who sponsored the bills in the Senate, also said they would not compromise I-STOP.
Israel, however, says that is not enough assurance. “Our opposition to the proposed changes is both personal and logical. The bills would create an opening for physicians not to report their opioid prescriptions. This directly reverses many of the fail-safes of I-STOP as a whole,” the letter to Cuomo stated.
At present, doctors are already allowed under I-STOP to issue an emergency prescription by phone for opioids but must within 72 hours report it to the state health department, Israel said. “By putting a notation in a patient’s chart, there is no more paper or electronic trail for investigators to follow for duplicate prescriptions or to investigate pill mill doctors.”
Save the Michaels of the World was started to honor Israel’s son Michael, who took his own life in 2011 after becoming addicted to opioids while being treated for Crohn’s disease. At the time, Michael had three opioid painkiller prescriptions from three different doctors.
Rich Azzopardi, the governor’s senior deputy communications director, said the two bills “are among the more than 500 bills passed by the legislature at the end of the last session (and) they remain under review by Counsel’s Office.”
The State Attorney General’s Office declined to comment on the two bills.