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Another Voice: I-STOP changes won’t hurt fight against opioid abuse

By Malcolm Reid and Thomas Madejski

The Medical Society of the State of New York (MSSNY) staunchly supports the need to reduce, prevent and eliminate opioid addiction.

Several points in The Buffalo News article, “I-STOP supporters urge Cuomo to veto bills they say would weaken prescription pill legislation,” need clarification. In fact, the efforts of physicians across New York State complying with I-STOP are a major reason for the huge decrease in “doctor shopping.”

Current law requires prescribers to consult the state’s prescription medication registry before they prescribe any controlled substance. This assures that patients are not “doctor shopping” for controlled substances from multiple prescribers. This I-STOP component of the law has been in effect since Aug. 27, 2013, and remains unchanged by proposed legislation.

On March 27, an additional component of the I-STOP law took effect. This portion of the I-STOP law mandates that all prescriptions for both controlled and non-controlled drugs be electronically filed. There are a few exceptions, such as a power failure, a prescription to be filled by an out-of-state pharmacy or when it would be impractical for a patient to obtain an electronically prescribed drug in a timely manner and the delay could adversely impact the patient’s medical condition.

However, the law requires that any time a paper or verbal prescription is used, the prescriber is obligated to send an email to the state Department of Health containing a burdensome amount of information.

The MSSNY supported legislation that will ease the administrative burden resulting from the patient’s need for expeditious relief, the patient’s need to fill a prescription out of state and/or transmission failures.

Electronic transmission of prescriptions has a 3 percent to 6 percent failure rate. Since 255 million prescriptions are filled each year in the state, between 7.6 million and 15 million are subjected to technological failure. It is unrealistic to expect prescribers to send an email each time an electronic failure causes a prescription to be handwritten or phoned into the pharmacy.

Again, the original purpose of I-STOP – the duty to consult the state’s registry before prescribing any controlled substance – has not been modified by the new legislation.

Twelve additional exceptions were announced by the Department of Health that do not require reporting to the department – which include compounded drugs, prescriptions that contain long or complicated directions and prescriptions for patients in nursing homes and residential health care facilities as defined in Article 28 of the Public Health Law.

Malcolm Reid, M.D., M.P.P., is president of the Medical Society of the State of New York. Thomas Madejski, M.D., is vice president of the society.

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