It’s a new and innovative program, supported by many pharmacies, and designed to combat the epidemic of prescription drug abuse in New York. At the same time, however, the very pharmacies that are backing the new and comprehensive program — called ISTOP, the first of its kind in the nation — prepare for a possible increased risk to their employees’ safety as a result of the innovation.
ISTOP stands for the Internet System for Tracking Over-Prescribing. It’s a database which, starting Tuesday, tracks daily all new prescriptions written in New York state for oxycontin, oxycodone, hydrocodone and other potentially addictive painkillers.
“Doctors are over-prescribing,” said New York Attorney General Eric Schneiderman about the reason he, State Senator Andrew Lanza and State Assemblymember Michael Cusick drafted the legislation that resulted in ISTOP coming into existence. In an extremely rare occurrence, ISTOP was voted into New York state law unanimously by the legislature.
The way ISTOP works is that as soon as a doctor prescribes a potentially addictive medication, the doctor enters that information into the system. When the patient shows up at a pharmacy to get the prescription filled, the pharmacist is immediately aware of the customer’s status.
“Now we can… check the database,” said Staten Island pharmacist Rob Annicharico, “and see, are they doctor shopping?”
That’s the practice of a patient finding any doctor who will fill a prescription, whether or not the patient is actually sick and in need of medication.
Teri Kroll knows about such situations firsthand. “We were recommended to a quote-unquote doctor, who was obviously a drug dealer,” the Long Island mother told PIX11 News.
In her interview, Kroll was wearing a bracelet bearing the name of her son, Tim, as well as his high school class ring. Tim Kroll died at age 21, about two years after he became addicted to his over-prescribed migraine drugs. He eventually died from addiction-related conditions, and the doctor who had over-prescribed Kroll’s medication, Dr. Saji Francis, was arrested, jailed and deported.
Teri Kroll and a handful of other parents lobbied for ISTOP, against powerful drug companies and medical organizations that had unsuccessfully argued that it would make it more difficult for patients with genuine needs for medications to obtain them.
“They could lobby all they want,” Ms. Kroll told PIX11 News, “but they were wrong.”
However, there is one effect of ISTOP’s introduction that creates a potentially risky challenge. The attorney general on Tuesday called pharmacies the first line of defense in the battle against prescription drug addiction, since they will be the first entities to challenge possibly addicted customers.
“I have a camera right behind us,” said Annicharico, as he pointed to one of a series of surveillance cameras he’s had installed inside and outside of his Richmond Avenue drugstore, “and we have panic buttons right underneath where I’m standing.”
He pointed to the space underneath the pharmacy counter, as he commented on how his business has had to steel itself for possible addicts entering and getting violent.
Annicharico not only counts himself among ISTOP’s biggest supporters, he introduced Attorney General Schneiderman when the state’s top lawyer announced the implementation of ISTOP at a ceremony on Tuesday in front of Annicharico’s drugstore. Still, the pharmacist said he understands that the possible dangers of operating under the new system may increase somewhat, even as it offers greater protections against people becoming addicted.
An armed man attempted to hold up Annicharico’s pharmacy a couple of years back. The pharmacist and a staff member were able to chase the suspect away. “God was on my side,” Annicharico told PIX11 News. He said that the man ended up later robbing another pharmacy. Nobody was hurt.
That was not the case on Father’s Day two years ago. That’s when admitted painkiller addict David Laffer killed four people in a Medford, Long Island pharmacy in his quest for prescription opioids, according to investigators.
Of course, that crime took place before ISTOP was even drafted as a bill. It’s difficult to dispute that the danger to pharmacy workers now that ISTOP is in place cannot be any greater than what the Medford pharmacy staff experienced.
A further risk, according to Attorney General Schneiderman, is that once prescription drug addicts are barred from getting their scripts filled more often than recommended, they’ll turn to over-the-counter, weaker drugs or to illegal street drugs to feed their habits.
That concern is real, said Schneiderman, but he added that ISTOP aim is preventive. “We’re talking about stopping people from getting addicted in the first place, like Teri’s son Tim,” the attorney general said, “and who then get hooked.”
Tuesday’s ISTOP initiation is only the beginning of New York’s program to stem the tide of prescription drug addiction. Next year, the state will also require electronic prescriptions. They’re intended to prevent prescription forgeries.