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State audit finds problems with opioid prescription tracking

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Office of the New York State Comptroller
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The New York state comptroller finds problems with the state health department's prescription monitoring program.

Opioid treatment programs in New York have not been using a state database that tracks opioid prescriptions, according to an audit from the state comptroller’s office released Monday.

New York’s I-Stop system is designed to reduce overprescription of controlled substances. It requires prescribers to record when they give a patient opioids, and it allows doctors treating people with opioid use disorder to check the database and make sure they’re not already getting the addictive drugs somewhere else.

That’s important because one of the treatment options for opioid use disorder is opioids. Gradually tapering the dose can help wean patients off the drugs while avoiding some of the worst symptoms of withdrawal.

“Without that information – without the outside prescriptions, the treatment programs don’t have the full picture of what a patient is receiving,” said Christopher Morris, who managed the audit.

But many prescribers have not been checking the database. “We found that treatment programs never checked I-Stop when they dispensed medications for patients to take home,” said Andrea Inman, the audit’s director.

The comptroller’s audit directly addressed the state health department with this concern. “We remind officials that state law requires treatment programs to consult I-Stop each time a take-home dose of opioid medication is dispensed. None of the treatment programs we visited were checking I-Stop in accordance with this legal requirement.”

Inman and Morris said this means patients with opioid use disorders are at risk of overdoses, and it increases the chance that the drugs can be distributed illegally.

The audit reviewed the treatment records of 25 people who received a total of 1,065 prescriptions for opioid use disorder over a four-year span. Their treatment providers checked I-Stop a total of 18 times.

“That’s low,” said Inman. “That is low.”

The state health department called the comptroller’s report “unrepresentative” and “misleading,” saying it focused on a small number of treatment providers.

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