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The I-STOP law: a doctor worries for his patients

Shawn Honnick

The new I-STOP law passed by the New York State Legislature is aimed at reducing the amount of overdoses on prescription painkillers; although some groups worry it might do more harm than good. This week on “Take Care,” we talk to Dr. Joseph Navone, president of the Upstate New York Society of Medical Oncology and Hematology, a group that specializes in pain and pain relief for patients.

Click 'Read More' to hear out interview with Dr. Joseph Navone.

I-STOP, short for Internet System for Tracking Over Prescribing, will create a database to monitor patients being prescribed painkillers. It also turns hydrocodone, a painkiller often given to cancer patients, from a Schedule Three drug to a Schedule Two drug. That means that a patient will have to visit with a doctor before getting a refill.

The Society for Medical Oncology and Hematology applied for an exemption from the law because they prescribe controlled substances to patients being treated for cancer, but was ultimately denied. Dr. Navone said that this could create a burden for cancer doctors.

“The nature of the oncology practice is that we are dealing with individuals who unfortunately may have advanced cancer that is incurable and most of the time these individuals require pain relief for their progressive disease as well as other supportive medications that help deal with things such as anxiety and depression,” Dr. Navone said.

Dr. Navone said that he believes that law will have three negative externalities, one being a decreased access to care. He said that doctors will spend more time consulting the database and unable to be there for patients. About 25 to 30 percent of Dr. Navone’s patients are prescribed a controlled substance.

“We’re already working in a very controlled environment and I sometimes feel that I’m spending more time documenting what I’m doing for my patients as opposed to sitting down face-to-face treating them,” he said.

Another consequence Dr. Navone worries about is that patients might be less willing to consult their doctors about symptoms of chronic pain. He said patients could worry about their names being put into a database and being grouped with people who are abusing prescription pain medication.

The most serious consequence Dr. Navone is concerned about is a decrease in willingness of patients to receive a prescription for a narcotic or follow the proper directions for taking the drug. He said cancer patients are often wary of becoming addicted to these painkillers, and the added precautions might scare people away from reporting pain or taking the medication when they really need it.

Dr. Navone says the law is well-intentioned and may cause a decrease in doctor shopping and unintended use of the drug, but overall he worries about the care of his patients who may need the drugs. He hopes that cancer patients will be exempt from the law in the future with legislative action.