Connecting Technology and Politics: How E-Prescribing of Controlled Substances Affected Opioid Prescriptions in New York City

When a family member, friend, or loved one develops an opioid addiction, few people know how to respond to it. Likewise, it is often difficult for healthcare providers to know how best to prevent, identify, and treat an opioid use disorder, and almost every health care provider in the country has had encounters with addicts. As trusted guardians of their patients’ wellbeing, providers are exploring how to use technology to expand their experience, skills and knowledge for improved care. Simultaneously with technological innovation, more and more states have adopted policies aimed at promoting the widespread adoption and use of technologies such as Prescription Drug Monitoring Programs (PDMPs) to view patients’ drug history and Electronic Prescription of Controlled Substances (EPCS) for pain management.

New evidence From ONC research shows that ordering PDMP pre-prescription exams and using EPCS technology to prescribe controlled substances in New York has helped reduce Medicare Part-D opioid prescriptions. In 2012, New York passed the Internet System for Tracking Over-Prescribing (I-STOP) Act to better regulate the flow of prescription pain relievers and other controlled substances within the state. Since March 27, 2016, the law has made it compulsory, among other things, to prescribe all prescribed drugs, including controlled substances, electronically.

How has the effect been so far?

The ONC study finds evidence that the I-STOP mandates reduced the number of Medicare Part D opioid prescriptions issued per prescribing physician and the number of Part D beneficiaries receiving opioids per prescribing physician per year. Opioid prescription spending decreased in the first year after launch, and there is evidence that prescribing doctors may have changed the frequency of their opioid prescriptions in response to the mandate.

The New York I-STOP Act is an example of a state law that uses health information technology, particularly EPCS, to combat the opioid crisis. Other states may consider similar approaches. When combined with other technologies such as PDMPs and clinical decision support applications, I-STOP can significantly reduce opioid use and overdose, as well as the cost of treating pain sufferers.