More New Yorkers find themselves addicted to doctor-prescribed narcotics, and increasingly the city is treating the problem as a public health crisis.
“Physicians have been taught for a long time that these drugs are safe -- that they can use them in large doses over a long period of time and that people will not get addicted and they will not have a drug overdose. That is not true,” said Dr. Thomas Farley, New York City's health commissioner.
To combat pain pill addiction, Farley’s office is launching a campaign that looks a lot like the city’s highly publicized assaults on sugary drinks, salt and smoking.
One prong of the attack features public service announcements, with grim depictions of opioid addiction running on Staten Island cable television.
This summer, the city will also send teams of educators to individual doctor offices to instruct prescribers on the dangers of opioids. Farley is concerned too many physicians are thoughtlessly writing oxycodone prescriptions for chronic pain, when the pills are more appropriate for acute pain associated with end-of-life ailments like cancer.
“We don’t want someone who is suffering from low back pain to turn that into dependence, addiction, or even worse, a drug overdose,” Farley said.
This month, the Health Department released a report showing opioid overdoses increased 65 percent – from 2 to 3.3 deaths per 100,000 residents – between 2005 and 2011.
The problem is especially pronounced on Staten Island, which has seen a steep rise in the rate of overdoses. While the rate of pain pill deaths rose across all boroughs, Staten Island’s rate was four times higher than in Manhattan, Queens or Brooklyn. Staten Island’s overdose rate was three and a half times higher than in the Bronx.
Among the pain pill casualties was Nicholas Clohessy, 18, a Tottenville High School football star. Shortly after his senior season ended, Clohessy, a team captain, began showing signs of opioid addiction. His older sister Kristen Clohessy said her brother was preparing to join the U.S. Marine Corps in a few weeks when he suddenly died.
The autopsy showed OxyContin and Percocet in his system.
“It’s the worst feeling in the world. I wouldn’t wish it for anybody,” Kristen Clohessy said.
“To see what my parents go through every single day. One of their children isn’t here," she said. "No parent should have to bury their child. Children should bury their parents.”
The Clohessy family is now calling for more oversight of doctors that prescribe high volumes of opioid pain killers.
“For a toothache, do I really need something like OxyContin?” Clohessy asked.
Last year, an I-Team investigation revealed many of the doctors who prescribe the most pain pills under New York’s Medicaid program are also the subjects of criminal and regulatory penalties. More recently, ProPublica found 10 of the top 20 prescribers of OxyContin under Medicare have been criminally charged, convicted, settled fraud claims, or have been disciplined by their state medical boards.
Tony Salters, a spokesman for the Centers for Medicare and Medicaid Services, told the I-Team his agency has only limited authority to revoke Medicare billing privileges for high-volume opioid prescribers.
“Payments may be suspended to a provider pending an investigation of a credible allegation of fraud,” Salters said.
That limited authority leaves many of the most flagrant opioid prescribers in apparent good standing with Medicare, even though they may be facing other criminal or regulatory charges.
For example, there’s no record that Felix Lanting, 86, was ever placed on the national Medicare exclusion list, even after he was criminally charged for running a pill mill that flooded Staten Island with 3,000 oxycodone prescriptions in just six months. Lanting ultimately admitted to illegally distributing oxycodone and surrendered his medical license.
A lawyer for Lanting had no comment for this story.
Salters says Medicare administrators recently submitted a proposed rule that would expand the program’s authority to suspend doctors.
Aside from efforts to educate doctors on the dangers of over-prescribing, the Bloomberg administration is pushing the Food and Drug Administration to revise opioid labeling to better reflect the dangers of addiction and overdose death.
When asked why Staten Island overdose rates are so much higher than other boroughs, Farley admitted he is flummoxed.
“I was surprised, and I don’t fully understand it. But I am very worried about it.”