With New York medical practitioners issuing more painkiller prescriptions in one year than the state has residents, the Senate passed legislation Monday meant to curb the illegal trade and illicit use of hydrocodone and other addictive opioid drugs.
One bill would reclassify hydrocodone, which is sold as Vicodin, Norco and Lortab, to the same restricted group as oxycodone. That would require a new prescription each time, with no refills. Another Senate-passed bill would increase criminal penalties for physicians and pharmacists who illegally divert prescription drugs.
"In 2010, New York practitioners issued 22 million painkiller prescriptions, not including refills," said Sen. Kemp Hannon, a Long Island Republican. "Twenty-two million, that's more than we have New Yorkers."
Hannon, who chairs the Senate Committee on Health, and Democratic Sen. Jeff Klein, who chairs the Committee on Alcoholism and Drug Abuse, presided at a discussion earlier Monday to address what they called a crisis. "I believe it rivals the heroin epidemic in the `70s," said Klein, who represents part of the Bronx and Westchester County.
Pharmacist John McDonald, the owner of Marra's Pharmacy as well as mayor of Cohoes, north of Albany, said access to prescription medications has "increased dramatically" over the past 15 years with more people insured. Police tell him that oxycodone that costs 30 cents a pill can sell for $40 each on the street, and the law prohibits pharmacists from taking back unused drugs. "We have no control over what happens when that patient leaves the pharmacy," he said.
New York regulations now require practitioners, including dentists, to report prescriptions they write monthly to the state health department, which is considering a shorter reporting period.
"We are currently looking at that to close the window," said Terence O'Leary, director of the department's Bureau of Narcotics Enforcement. Gov. Andrew Cuomo is looking at a comprehensive approach to solve the problem, and tougher criminal penalties are only one part of it, he said.
"Doctor shopping is a huge issue," with patients trying to get additional prescriptions for more pills, said O'Leary, a former drug prosecutor. Patients are required under state law to tell their doctor if they are getting a controlled substance from another doctor. He said one study showed three-quarters of abused prescription drugs came out of people's medicine cabinets.
A bill backed by the state's Democratic Attorney General Eric Schneiderman would curb the black market by requiring "real time" online review and reporting by prescribers and pharmacists of each prescription written and filled for a patient. The bill now has 30 Senate and 47 Assembly co-sponsors.
The attorney general's office cited federal data showing an increase from 1998 to 2008 of drug treatment admissions from 2.2 percent to 9.8 percent for painkiller abuse, with emergency department admissions from misuse or abuse of pharmaceuticals doubling between 2004 and 2009.
Dr. Joseph Sacco, director of palliative medicine consultation at Bronx Lebanon Hospital Center, said 99 percent of doctors are well intentioned but many are "poorly informed" and need better education on pain management and addiction. They frequently undermedicate for pain, and legislators should be careful not to frighten them from prescribing effective and needed analgesics, he said. "The education piece is extremely important," he said.
Parents of one teenager and the mother of another who both became addicted to painkillers when suffering from chronic medical conditions -- Crohn's disease in one case, severe headaches and anxiety in the other -- described how their sons gradually became addicted, struggled, and eventually committed suicide. They urged the legislators to make sure that never happens again. Teri Kroll said the doctor who was prescribing oxycodone for her son Tim was later sentenced to six months in jail and deported for selling the drug to undercover police.
Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence, said the solution isn't simply more law enforcement to stop the flow, but also dealing with people who have developed problems. "Addiction left untreated is a fatal disease," he said.