The I-STOP law: an assemblyman's push to solve a big problem

Aug 25, 2013

Prescription drugs can be helpful to those that need them. But for others they can be dangerous or even deadly. This week on “Take Care,” we talk to New York State Assemblyman Michael Cusick, the lead sponsor behind a piece of legislation called I-STOP, or Internet System for Tracking Over Prescribing, which is intended to serve as a national model to end prescription painkiller abuse.

Click 'Read More' to hear our interview with Assemblyman Cusick.

Prescription painkiller abuse is on the rise. Prescriptions for drugs like oxycodone rose 35 percent over a three year period in New York state. USA Today reported that in 2010 38,000 people died from an overdose of prescription painkillers.

Cusick, a Democrat who represents the 63rd District on Staten Island, said this issue is bigger than it seems. He was inspired to push for legislation on the issue about two years ago when he saw that there was a staggering amount of painkiller abuse going on in his own district.

“This is a statewide and national issue that is hitting all of us in one way or another,” he said.

The assemblyman admitted that it is difficult to eradicate painkiller abuse nationally, so he looked at what was possible on the state level. He found that many cases on Staten Island and in New York City involved “doctor shopping,” or patients finding doctors who will easily prescribe them painkillers, even if they have prescriptions from another doctor.

I-STOP will provide a real-time database where doctors and pharmacists can check to see if patients have prescriptions for painkillers and who the doctor giving the prescription is. The bill also mandates that doctors do away with the traditional pad and paper for writing prescriptions and use an online program called E-Prescribe by 2014.

In addition, I-STOP made hydrocodone - a painkiller similar to oxycodone - a Schedule Two drug when it was previously a Schedule Three. That means that a patient must go back to his or her doctor before getting a refill, which Cusick admits might be irritating for some.

“This will be an annoyance for patients that really need or rely on the medication, but we feel that this is a very highly abused drug illegally so we wanted to up it to a Schedule Two,” he said.

The law also includes a teaching component where doctors must receive proper education before being able to prescribe painkillers. Previously, Cusick added, a monitoring system was in place, but only on a volunteer basis.

The law, which goes into effect August 27, was a joint effort with Republicans and Gov. Andrew Cuomo’s office, Cusick said. In 2010, when the bill was just being introduced, Cusick said he held a roundtable with doctors, pain management experts, counselors, pharmacists and families of those that have died of painkiller overdoses to discuss the possible impact of the law. The legislation also includes a working group that will monitor it and fix any glitches.

“We understand that there are going to be different sides to approach this and we are willing, we are able and we are open to work will all folks involved,” he said.

I-STOP does make exceptions to these rules for patients in hospice, who generally have six months or less to live. However, there are no exceptions for cancer patients who routinely use these drugs to deal with intense pain. Cusick said it would be up to the monitoring team to make adjustments.