Deputy Mayor Linda I. Gibbs, Chief Policy Advisor John Feinblatt and Health Commissioner Dr. Thomas Farley today released new data showing that opioid painkiller prescriptions are rising in New York City and that 8,000 health care providers (15 percent) prescribe the majority of the drugs (82 percent). The Mayor’s Task Force on Prescription Painkiller Abuse, co-chaired by Deputy Mayor Gibbs and Chief Policy Advisor Feinblatt, proposes strengthening the state’s drug monitoring system so that it has more timely and complete information, requires doctors and pharmacists to consult the database to prevent overprescribing or misuse and allows information in the database to be shared with local agencies working on the ground to address the problem.
“In the face of opioid abuse, it is critical that we educate providers, pharmacists and patients on the potential dangers of painkiller misuse or overuse,” said Deputy Mayor Gibbs. “Strengthening our drug monitoring system will help us work together to ensure that well-intentioned providers don’t inadvertently overprescribe these pills – with potentially dangerous consequences –and that we have the information we need to investigate those who are actively engaging in criminal behavior.”
“Our report shows that some doctors are prescribing prescription painkillers at an alarming rate, and data is the key to turning the tide,” said Chief Policy Advisor Feinblatt. “With access to data on the prescribing of painkillers, local public health and law enforcement agencies would be able to play a key role in preventing overprescribing, identifying suspicious prescription patterns and keeping criminals from preying on those who are fighting addiction.”
“The problem often begins with us, as physicians,” said Health Commissioner Farley. “Primary Care physicians, pain management and other specialists, including dentists, can reduce the risks of misuse and overuse of opioid medications by prescribing them much more cautiously.”
The Mayor’s Task Force proposes strengthening the State’s prescription drug monitoring program by requiring doctors and pharmacists to check an improved system at the time of prescribing and dispensing and to input prescription information into the system in real or close to real time to ensure that providers and pharmacists use it to prevent overprescribing, fraud or criminality. The Task Force also highlighted the potential benefits of sharing data with local public health officials, Medicaid enforcement agencies and law enforcement, with appropriate protections. With better access to information, these local agencies can target education to providers, pharmacists and patients and bring enforcement actions against those selling drugs illegally to profit on the black market.
The data the Health Department released today also demonstrate the need for increased training of doctors and pharmacists and education of the public, two areas of focus for the Task Force. The Task Force has identified the benefits of requiring doctors who prescribe very high dosages of opioids to take eight hours of training in prevention and the management of opioid dependence, and requiring that doctors give patients written warnings about the risks of taking opioids since patients are often unaware of the dangers these drugs pose in terms of addiction and abuse.
Opioids reduce pain but can also be dangerous because they can lead to addiction or fatal drug overdose. An analysis of State Health Department data shows that opioid prescriptions rose 22 percent between 2008 and 2010 and, according to New York City data, overdose deaths attributable to opioids have increased 30 percent since 2005.
Health Department guidelines released in December 2011 advise prescribers to consider opioids for acute pain only if the severity of pain warrants their use, to avoid opioids for chronic non-cancer pain unless other treatments have not worked and to clearly communicate the risks of prescription opioids to their patients.
Over the past twenty years in the United States there has been a ten-fold increase in the use of prescription opioids (commonly known by the brand names Percocet, Oxycontin and Vicodin, among others). Oxycodone accounted for nearly half of all opioid prescriptions to NYC residents in 2010. Almost three quarters of opioid prescribers were physicians; the remainder were dentists (16 percent), physician assistants (6 percent) and nurse practitioners (6 percent). While most (85 percent of) prescribers wrote less than one opioid prescription per week, the remaining 15 percent of prescribers wrote 82 percent of opioid prescriptions filled by New Yorkers in 2010.
In 2010, City residents filled more than two million opioid prescriptions for a median of three prescriptions per person. Staten Island had the highest rate of prescriptions filled per person followed by Manhattan, Bronx, Queens and Brooklyn. The report also indicates that nearly half (49 percent) of opioid prescriptions were paid for with commercial insurance and one in five (21 percent) by Medicaid.
The Task Force, which was announced December 2011, includes Commissioner Farley, Human Resources Administration Commissioner Robert Doar, NYC Health and Hospitals Corporation President Al Aviles, Special Narcotics Prosecutor Bridget Brennan, Dr. Adam Karpati Executive Deputy Commissioner at the Department of Health, Director of Analytics for the Office of Policy and Strategic Planning Michael Flowers, Director of New York/New Jersey High Intensity Drug Trafficking Area Chauncey Parker; Staten Island District Attorney Daniel Donovan and Director of Health Services Andrea Cohen.