State laws aim to curb opioid overprescription and abuse

Aug 3, 2015

The Centers for Disease Control and Prevention says there’s the equivalent of one bottle of prescription painkillers for every adult American. Meanwhile, 46 people a day die from an overdose of those same painkillers. That’s why New York State is trying to curb the problem of overprescribing.

“So much of today’s heroin problem is due (in my judgment) to yesterday’s over prescribing of opiate substances which in effect is synthetic heroin,” says William Hochul, the U.S. Attorney for Western New York, “Doctors had the right to prescribe them for legitimate medical purpose, but unfortunately, in some cases profit motives clouded their judgment and they became drug dealers in lab coats.” Leading experts in medicine and law enforcement agree him with on this.

A University at Buffalo study found 3 in 4 people in treatment for heroin, used prescription opioids first.

Shannon, 31-years old, became addicted through drugs from the family medicine cabinet. “I started Oxycontins when I was 14, became physically dependent by the time I was 15, and switched to heroin by the time I was 17, probably.”

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In an effort to disrupt that pathway to addiction, state lawmakers created I-STOP--or the Internet System for Tracking Over-Prescribing. The laws went into effect in 2013 and require doctors to register and track prescriptions before writing a new script for a patient. The State Department of Health says the measure has helped decrease the total number of opioid prescriptions by nearly 9 percent.

Sam Quiñones, former L.A. Times reporter, has covered the growth in heroin abuse nationwide. In his book “Dreamland: The True Tale of America's Opiate Epidemic,” Quiñones explains the how the 1990s saw an increase in prescriptions for opioid painkillers. He says most doctors prescribed in good faith, believing marketing from Purdue Pharma that described OxyContin as “less addictive.”

“In a lot of cases, people did, people could use these without much risk, but there a whole bunch of people who they couldn’t prescribe them to risk free and these people got addicted and there was a huge amount of collateral damage,” says Quiñones.

Dr. Richard Blondell oversees the University at Buffalo Addiction Medicine program. He says the best approach is to prevent people from becoming addicted in the first place, by educating physicians and communities about addiction. He confirms the clear connection between painkillers and heroin.

“If we let the healthcare system create drug addicts and then discharge them from the healthcare system, the dealers in the illicit marketplace will be right there,” says Blondell.

New York Attorney General Eric Schniederman sees I-STOP as part of the solution, but he wants the federal government to go further to curtail the proliferation of prescription opioids.

“The federal government spends hundreds of billions of dollars paying for people’s health care. So, they buy the oxycodone and then our tax dollars have to cover the treatment. So, we get hit on both ends,” says the Attorney General.

For a national perspective, a 2013 report by the Health and Human Services Inspector General found more than 700 general-care physicians with questionable prescribing practices.

Meanwhile, Shannon has been in successful treatment for her long-term addiction for 2 years. She wishes more people realized the risks associated with narcotic pain medication.

“You start with not supervising your kids in the medicine cabinet and leaving stuff around. They start stealing Vicodin and eventually it’s going to lead to heroin.  I mean, not every case ends up like that, but most people I know that are addicted to heroin that’s how they started: riffling through their parents’ medicine cabinet,” says Shannon.

All provisions of the I-STOP laws, including the delayed requirement for all prescriptions to go electronic, go into effect March 27, 2016.