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PR- 125-13
April 3, 2013


New York City Task Force Has Been Leading Efforts to Track and Reduce Painkiller Misuse, Issue Prescriber and Emergency Room Guidelines and Educate Patients About Dangers of Abuse

The following is the text of Mayor Bloomberg's remarks as delivered at the Omni Orlando Resort in Orlando, Florida this morning:

“Thank you, thank you very much. Steve, thank you for that overdone, but I loved it, and I loved the story about you can tell a New Yorker, but not much. I will use that, probably without attribution – I will be shameless and just plagiarize it.

“Let me start out by saying there’s somebody here who is really making a bigger difference in this world than I do, and that I’ve been lucky enough to work with and know for a while, and that is Chairman Hal Rogers, and his lovely wife Cynthia who puts up with him.

“As head of the Appropriations Committee in the House, he really has enormous amount of power to decide what things we have to focus on and what things we don’t. And this is a guy who is a doer and understands that we’re here to help people. And he’s done a great job in his state, but now he’s doing it on a national scale. And I just think he deserves a real round of applause.

“In order to be here, I flew down this morning. Orlando and New York City are in a friendly competition for the title of America’s most popular tourist destination. I will not mention which city won the last two years in a row, but both cities do have a lot to offer. Orlando has the Little Mermaid and we have the Naked Cowboy in New York City. Orlando has Lady and the Tramp, and we have Lady Gaga. We both have famous boardwalks full of colorful characters. So while it’s great to be here, I hope you’ll all get a chance, seriously, to visit us in New York City. You’ll have a blast, and we could definitely use the tax revenues.

“Let me commend, and I’ll start with the organizers of this important summit. It is a very important thing and we appreciate everything that people like Hal and all of the people who work on this problem are doing. This is work that could not be more important. We have a problem in this country that is growing every day, and many Americans don’t know about it until it tragically can strike their family.

“Prescription drug abuse is often thought of as a suburban problem – but the truth is, whether it is in rural Kentucky or a big city like New York, we’re all facing the same problem: an ominous spike in the abuse of prescription painkillers.

“Dr. Tom Frieden – Tom, aren’t you supposed to be in Atlanta working – Tom Frieden, the director of the Centers for Disease Control and Prevention – and before that, the person that I appointed to run New York City’s Health Department, and he really deserves an awful lot of the credit for our smoking cessation work – he has called this a national public health crisis. And I think Tom would agree, it’s also a public safety crisis, as well.

“We saw that last week in New York. City and Federal law enforcement officials made nearly 50 arrests and seized more than 30 weapons as they broke up two major drug rings that had put half a million powerful painkillers on the black market. So this morning what I wanted to do was just briefly sketch in the dimensions of this crisis in New York City, and also describe the steps that we have taken there, or are about to take, to address this particular problem.

“Fifteen months ago, I appointed an interdisciplinary Task Force on Prescription Painkiller Abuse. The Task Force includes representatives from the worlds of public health, health care, and law enforcement.

“My experience has always been that in both the private and public sectors there’s something that if you can’t measure it, you can’t manage it, and so our Task Force began its work by trying to get a really full and accurate picture of this problem – and it is a very sobering problem, in fact, when you look at it.

“Some of you here may have seen a detailed presentation yesterday by representatives of our Task Force – so I won’t repeat it in full. But it’s worth repeating that one of the Task Force’s key findings: more than a quarter-million residents in New York City report either misusing the opioid painkillers that have been prescribed to them or abusing painkillers that haven’t been prescribed to them.

“In either case, that behavior is a very serious health risk and the Task Force found that lots of people are dying because of it. That report showed that between 2004 and 2010, the number of painkiller-related emergency room visits in our city increased by 143 percent.

“Between ‘05 and ‘11, unintentional overdose deaths involving opioid analgesics in our city increased by 65 percent, even as overall drug overdoses in our city declined. In fact during 2011, fatal painkiller overdoses occurred at a rate of more than one every other day. So it’s clear that painkillers are causing an awful lot of pain – and certainly also an awful lot of deaths.

“This is, by any definition, truly a crisis, and it’s a crisis that’s growing, one with both public health and public safety dimensions as I said. Not only does painkiller addiction threaten the health and the safety of those who abuse these drugs, it can also produce criminal behavior, ranging from Medicaid fraud to hold-ups at neighborhood pharmacies, or other violent crimes.

“We’ve seen these problems all across the country – and New York City is no exception. In fact, during the past 18 months there’s been a number of  drugstore robberies in the New York City region and that have resulted in shooting deaths of store employees and customers, of robbery suspects, and in one instance in suburban Long Island, the death of an off-duty Federal law officer who attempted to stop a robbery.

“At the same time, with felony drug arrests having gone down in New York City, arrests for prescription drug related offenses has gone up, and up sharply. This clearly demands aggressive action – and we’re trying to attack this on both the public health and public safety fronts.

“Let me start with what we’re doing in public health care. Our work is based on the recognition that most painkillers that are being misused have been legitimately prescribed – and that makes it even harder to do something about it – although often in doses and for durations and for reasons that aren’t justified by good medical practice.

“This is a big problem – and in the end, it’s really up to doctors and other medical professionals to solve it. That’s why the medical professionals on our Task Force have developed and distributed guidelines that urge physicians to prescribe these potentially dangerous drugs much more carefully – and to recognize that overprescribing them can lead to addiction or even to death.

“And incidentally, for doctors they should start paying attention because the legal liabilities if they are found to have done it knowingly are severe and we’re going to focus as a society an awful lot more on trying to go after those who are abusing their position.

“At the same time we released the Task Force report that I just described, we also announced new emergency room guidelines on prescribing opioid painkillers. These voluntary guidelines have been adopted in all 11 of our City’s public hospitals, and also in at least eight of our non-public hospitals, as well.

“Such measures are very important because, as most of you know, emergency departments play a critical role in providing pain medication – and also in dealing with the effects of pain killer abuse.

“New York City hospitals have adopted these guidelines and are now posting them prominently in their emergency departments. We have posters in English, and Spanish, and Chinese, and Russian to tell patients that one, these powerful painkillers can be very dangerous; two, that they shouldn’t ask for them unnecessarily; and three, they should only use them as prescribed by a doctor.

“The guidelines also clearly state that emergency departments will not prescribe long-acting opioid painkillers, such as OxyContin; in most cases, they will not prescribe more than a three-day supply of opioid painkillers; and they will not refill lost, stolen, or destroyed prescriptions.

“Our Task Force has also helped strengthen the ‘prescription drug monitoring program.’ New York State does have a database – similar to systems in most other states – that collects information about the sale of controlled substances. That’s important, because data helps us focus our law enforcement efforts.

“For example, the Task Force looked at data from 2,100 pharmacies across New York City and found that just 1 percent of them accounted for a quarter of the highest prescription oxycodone being sold – and that could point to criminal activity. And I think that pattern is exactly what you see on a lot of things – it is a very small percentage of people that break the law or don’t act responsibly, and unfortunately that very small percentage can do enormous damage to human life.

“A year ago, we worked to pass a new State law to make better use of the database. One result is something in our State law which is called ‘I-STOP’ – an acronym for Internet System for Tracking Over-Prescribing – and that’s going to go into effect this summer. It creates new tools to detect and prevent negligent, or fraudulent, distribution of controlled substances.

“For instance: doctors and pharmacists will now be able to see a patient’s controlled substance history on-line – and doctors will be required to check this State database before prescribing any controlled substance; pharmacists will be required to put information into the State database in real time as they dispense controlled substances; and, by 2014, under this law all doctors will be required to send prescriptions for controlled substances to pharmacies only via computer, with the goal of eliminating the all too common forgery or theft of paper prescriptions.  

“These ‘I-STOP’ reforms will also give State authorities greater flexibility in sharing information with local public health officials – something that’s going to help us detect negligence or deceit in dispensing prescription painkillers.

“Information sharing is also critical to law enforcement, as everybody knows. The City’s Task Force, working with State and Federal law enforcement officials, has created a new and sophisticated system for information-sharing across agencies.

“It’s called ‘NYC Rx-Stat’ – a name that alludes to New York City’s widely imitated CompStat system of tracking crime patterns in our city. Rx-Stat’s activities will include periodic reporting to public health and public safety officials on data and trends that will lead to innovative new ideas in stopping pain killer abuse. We think also give the public information so that the public can demand that their elected officials don’t walk away from this problem.

“If Hal Rogers and Mike Bloomberg can face it and try to do something about it, so can the others. And if they don’t want to do it or are too lazy to do it, the public can hold their feet to the fire if the public has information, and I think this will do that.

“Rx activities include the kind of period reporting that public safety officials will use to stop trends and to come up with innovative new ideas to stop pain killer abuse. For example, Rx-Stat lets the NYPD use Health Department data to target education campaigns to communities where prescription drug abuse is most prevalent.

“In that same spirit of cross-agency collaboration, detectives from the NYPD are now working with the Federal Drug Enforcement Administration to investigate prescription drug crimes – and that investigation that broke up the major painkiller drug rings that I mentioned earlier in my talk.

“The NYPD also has launched an innovative initiative to catch and deter drugstore burglaries and holdups by thieves who are going after prescription painkillers. Last month, the first of what we expect will become a large number of our city’s approximately 1,800 pharmacies began stocking ‘decoy’ bottles of OxyContin.

“These ‘bait bottles,’ as they’re called, which have been created by the manufacturer of OxyContin, Purdue Pharma, don’t have any pills in them. Instead, very cleverly they hold small GPS devices that will enable officers to track thieves immediately after robberies or burglaries takes place.

“It is getting to be Big Brother, but Big Brother has a role to play as well in terms of stopping our kids from dying from using painkillers, and we’ve got to use all the technology that’s available to try to stop some of these crazy things.

“We have to see, of course, how this whole program pans out – but we are optimistic, we think it’s very promising, and it’s another example of how we’re trying to stay ahead of the criminals. And shame on us if we don’t try all of these things. Even sometimes things that don’t work, at least we’ll know what does work and what doesn’t.

“Over the past 11 years, we’ve used these types of innovative strategies and we’ve driven crime down more than 30 percent – to record lows in New York City. Last year we had the fewest murders in modern memory. We used to have, 20 years ago, something like 2,300 murders a year; last year we had 419, and this year we are, after a quarter of  the year, we’re running 29 percent lower than last year. So we’ve made a big difference there.

“Steve talked about life expectancy – it is two years higher than the average across America, it’s about three years higher than it was 11 years ago when we came into office. And one of the things that’s making a difference is trying to get things like prescription drugs that shouldn’t be in the wrong hands away from kinds who would abuse and unfortunately OD on it. And it’s also a function of a much lower murder rate; it’s a function of building codes that stop fires and response time for ambulances, which we focused on, which are at an all-time low. If you have a stroke, a few seconds early, on average, can make a big difference.

“So we’re doing a lot of things. The smoking cessation program, there are 10,000 fewer people dying every year in New York City from smoking. And also I’m trying to focus on something that will be an even bigger killer than smoking someday, and that is obesity which has become a worldwide problem. It is a problem in the cities and rural areas and everyplace between. This year, for the first time in the history of humanity, more people will die from overeating than from starvation. Just think about that, and it’s all come about in the last 20 years.

“In New York City, this year, more people will die from the effects of obesity than from smoking, because the smoking deaths have been coming down and obesity is just skyrocketing, and we have to do something about this.

“I’ve always believed that protecting the lives and health of our people is the first responsibility of any government. After all, if improving the quality of life isn’t government’s job I don’t know what government’s job is. We take our work very seriously.

“Sometimes people don’t like it – I remember when we banned smoking ten years ago and I did one of these parades – New York has parades all the time, we have three weekends of St. Patrick’s Day parades, and this Sunday I will do the Greek Orthodox Parade, which I missed about four years ago, they still have not forgiven me for that – but when we first put the smoking ban in, as you would go by a bar you got a lot of one-fingered waves.

“Today, we did an event last week, the tenth anniversary of smoking cessation in a bar that’s been open since 1870 or something like that, and the owner and the bartender for 27 years there and the waitress for 23 years were at our press conference which we had in the bar. These were three of the most vociferous anti-any control on smoking people you’ve ever heard if you go back ten years, and today they’re 100 percent converted. Their business is better than ever, and they’re living longer. Most big cities in America have now banned smoking in bars and restaurants and offices, and when you go into a place that does allow smoking all of a sudden you start gagging.

“I’ll tell you one quick story, there was a governor of an adjoining state who called me and said, ‘Thank you for the smoking ban, you have helped my state more than anybody else. Everybody’s going to come from New York City into my state and eat and drink there every night.’ And three months later the Governor called me and said, ‘I just wanted you to know that I just introduced a bill identical to New York’s to try to ban smoking.’ And I said why? And the Governor said because their son had not spent one night in their state since the smoking ban went in.

“So you can make a difference, and I was confident that our public health and public safety efforts – in this case, to stop prescription pain killers – are going to make a difference. And the people that are really standing up here, whether it’s in Washington or your State Attorney General who I met earlier who’s been helpful, or people that run this organization, they understand that we have an obligation to help each other and we are making a big difference.

“So thank you for having me here. I have to go back to New York to earn my $1 a year. They won’t be happy when they found out I was out of town. Thank you, God bless.”


Marc La Vorgna/Samantha Levine   (212) 788-2958


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