New York State Office of the Attorney General's INTERNET SYSTEM for TRACKING OVER-PRESCRIBING (I-STOP): A Proposal Addressing New York’s Prescription Drug Abuse and Drug Diversion Epidemic

The Attorney General's Office has issued this report on Prescription Drug Abuse. NYSAM and MSSNY do not necessarily agree with all these proposed remedies. This issue will be discussed at NYSAM's Public Policy Forum on Friday, February 3, 2012 at the New Yorker Hotel. For more information on the Public Policy Forum, please contact Sherry LaFountain at (518) 689-0142 or via email: slafountain@asapnys.org.

American Medical Association's Prescription Drug Monitoring Programs

To view AMA's full article on Prescription Drug Monitoring Programs, please click here.

You may also be interested in reading the long report from the AG's office at

 http://www.ag.ny.gov/media_center/2012/jan/ISTOP%20REPORT%20FINAL%201.10.12.pdf

Prescription Drug Abuse: What is happening to address the problem

Prescription drug abuse is in the headlines. Many groups are trying to address the issue and NYSAM is involved. The white house Office of Drug Control Policy has a position statement and legislation has been introduced to congress around this issue. ASAM is developing a national statement, which should be released in the next few months. It will particularly address the educational requirements, if any, for obtaining a DEA number. ASAM is trying to propose a balance between encouraging good medical care but not discouraging the use of opioids by physicians when it is appropriate ASAM is also interested in expansion of the prescription-monitoring program. OASAS has a committee with several NYSAM members on it, which is developing some recommendations.  NYSAFP is working on getting the state to improve their prescription-monitoring program so that the doctor can find out if one of their patients is being prescribed controlled substances by any other physician. The Attorney Generals office is proposing very strict guidelines and physicians could be found medically negligent, pay fines and loose their license if they violate these very strict guidelines. There is legislation in both the assembly and senate. Some would be so onerous that doctors might decide never to prescribe opioids where as other legislation would find doctors negligent if they do not prescribe opioids.

NYSAM is involved. Our public policy committee has been discussing these and has come up with two recommendations that our board has approved. These recommendations are different that other proposals in that they ask the insurance companies to become involved in terms of providing quality measures and education, plus increasing payment for time taken to properly evaluate and prescribe these medications.

Most importantly, we are hosting a Public Policy Form on this subject Friday, February 3, 2012 before our Annual Meeting Friday night and scientific sessions on Saturday. NYSAM members will start by outlining the issues. Legislative leaders and representatives form the health department and attorney general office are being invited to dialogue with us. WE hope as a result of this meeting we can have some influence on the legislative and regulatory process. Our public policy committee wills then follow-up with individual meetings in Albany and join AAFP and MSSNY, when we agree, in their lobbing efforts.

Public Policy Forum: Friday, February 3, 2012  2:00 pm  to 4:30 pm, The New Yorker Hotel, 481 Eighth Avenue, New York, New York.

Speakers from NYSAM

Andrew Kolodny MD: overview of the problem

Kelly Clark: MD  A study of ER prescriptions in New York State

Steven Kipnis MD  OASAS efforts to reduce t he problem

Sharon Stancliff MD prevention of deaths from overdoses

Norman Wetterau MD positions of ASAM and NYSAM

Invitations have been sent to the Attorney Generals office, Health Department, and chairman of the assembly and health committees and other selected legislators.

This forum I open to any physician, not just NYSAM members. There is no charge

Prescription Drug Abuse: Report from the New York Society of Addiction Medicine

Much is being proposed to help reduce the prescription drug abuse problems in New York State. NYSAFP and MSSNY have both made suggestions. The American Society of Addiction Medicine is preparing a position paper that will address provider education and prescription monitoring programs. The New York Society of Addiction medicine is bring forth two other suggestions which we hope will be considered as solutions are sought for this problem in our state.

1. NYSAM encourages the development of quality indicators related to the prescribing of controlled substances.  For example, some doctors never do urine drug screens and insurance companies and Medicaid know this, but never suggest it. The same can be said of other important quality indicators. Physician organizations, insurance companies and other payers should develop these indicators, provide education around them and use them t help improve patient care. 

2. Physicians should receive adequate reimbursement for the evaluation and management of patients on controlled substances. It takes just a minute to write a prescription and the patient usually leaves happy. It takes more time to evaluate whether a patient is a good candidate for a potentially addicting medication.  For the optimal management of chronic pain patients, old records need to be reviewed, and there is a need for patient education and careful follow-up. These services are not adequately reimbursed. Insurance companies pay for expensive injections and for opioid prescriptions but they often do not pay for counseling or comprehensive multi-disciplinary team approach, even though studies show that this is often the most effective approach to chronic pain problems.

Prescription Drug Abuse

NYSAM is concerned about prescription drug abuse. We plan to have a Public Policy Forum in New York City on Friday, February 3, 2012 from 2:00 pm to 5:00 pm, the day before our 8th Annual Scientific Conference at The New Yorker Hotel, 481 Eighth Avenue, New York, New York.

At the forum, we will have several of our members speak and then have several members of governmental agencies, the assembly and state senate speak. Much of the three hours will be spent in discussion and dialogue.

On our website, we have previous testimony given to a Assembly Committee last year. Below is what the NYSAM Public Policy Committee has developed so far this year. We want input from all our members.
Do you agree with what we have written so far? What additional ideas might you offer. Please reply through the website www.nysam-asam.org or e mail Norm Wetterau at  normwetterau@aol.com.
You do not have to be a member of our Public Policy Committee to have this input. Please mark your calendars for these two important events.

In order to provide optimal care for a patient, a physician must be aware of the medications that patient is already taking.  It is well known that some patients are receiving controlled substances in excess of recommended dosages, receiving prescriptions from multiple providers, and misusing the medications. These patients often do not volunteer this information to the physician. NYSAM believes that knowing if a person is receiving prescriptions for controlled substances from other providers before prescribing any potentially addictive medication, proper prescribing, and careful follow-up are part of providing good medical care. We are therefore offering these suggestions that might help patients all over New York State receive the best possible treatment:

1.        Physicians should have online access to information on all
controlled substances prescribed for his or her patient. Right now such access is very limited.  If only one change can be made in the current rules, it should be this:  Such access should be easy to obtain but only available to the patient's physician, PA or NP.

2.       Physicians should receive adequate reimbursement for the evaluation and management of patients on controlled substances. It takes just a minute to write a prescription and the patient usually leaves happy. It takes more time to evaluate whether a patient is a good candidate for a potentially addicting medication.  For the optimal management of chronic pain patients, old records need to be reviewed, and there is a need for patient education and careful follow-up. These services are not adequately reimbursed. Insurance companies pay for expensive injections and for opioid prescriptions but they often do not pay for counseling or comprehensive multidisciplinary team approach, even though studies show that this is often the most effective approach to chronic pain problems.

3.       NYSAM encourages quality indicators related to the prescribing of controlled substances. Some doctors never do urine drug screens and insurance companies and Medicaid know this, but never suggest it. The same can be said of other important quality indicators.  Insurance companies and other payers should develop these indicators and use them to help improve patient care.

4.      Education should be available for all who presecribe controlled substances, but only required for those who are having problems. Doctors can attend a course but not change the way they do things. If Medicaid and insurance companies had quality indicators, that would help determine which doctors are doing a good job prescribing. Providers who are doing a good job should not be required to take such a course. Many of them have already taken similar courses, or have read extensively on the subject.

Preventing Overdose Deaths: 911 Good Samaritan Resolution

Resolved, That the MSSNY support efforts that would enact a " 911 Good Samaritan "law that would provide immunity from arrest, charge, prosecution and conviction for drug and drug paraphernalia possession and for  certain alcohol related offenses for individuals or victims of a health related emergency which resulted due to consumption or use of a controlled substance or alcohol and who have contacted 911 in good faith to receive emergency medical treatment for themselves or another individual.

To review a copy of the Resolution, please click here.