MSSNY eNews: “Take Back” Program Can Save Lives
Thomas J. Madejski, MD
June 29, 2018
Volume 20 Number 24
There are many steps that can be taken to address the opioid abuse crisis in New York and across the country.
One way is to prevent opioid medications from getting into the wrong hands by providing more convenient access to medication disposal sites.
More Convenient Method for Public to Dispose of Unused Medications
Before leaving Albany for the year, the New York State Legislature took an important step by passing legislation (S.9100, Hannon/A.9576-B, Gunther) supported by MSSNY that would create a comprehensive statewide program to better enable the collection of unused prescription medications, such as opioid medications. This program would be paid for by the manufacturers of these medications. The goal of this program is to assure a more convenient method for the public to dispose of these unused medications, rather than relying upon the limited number of “drop boxes”, designated collection days, or by flushing them.
We know too well the consequences of letting these medications sit in medicine cabinets. We are hopeful that development and promotion of such a “take back” program can cut off one avenue to addiction.
I’ve had a personal interest in this issue for a number of years. The MSSNY delegation to the AMA had suggested a study on medication recycling a number of years ago. That resolution was defeated; but I’m pleased that our continued advocacy for closing the loop of potential diversion and pollution are about to bear fruit.
Ultimately, in 2016, the MSSNY House of Delegates adopted policy calling for the enactment of such a take back program to be paid for by the manufacturers of these medications. Our policy was then adopted by the American Medical Association during its 2016 Annual Meeting.
Urge Governor Cuomo to Sign Bill into Law
The Legislature’s passage of this bill is not, however, the final step. It still must be signed into law by the Governor. With the bill having been sent to the Governor for his consideration yesterday (he must take action by July 11), physicians are urged to contact Governor Cuomo to request that he sign this measure into law by clicking here.
The existing limited programs are helpful but must be supplemented. In 2015, a law was enacted that permitted pharmacies and other DEA authorized collectors to collect unused controlled substances in New York. While this was an important step in making it easier for people to take back their unused medications, voluntarily participation remains low. The Department of Environmental Conservation also operates a pilot program that provides take back receptacles at participating pharmacies, hospitals and long-term care facilities, but this program is voluntary and limited in scope.
And last year, a bill was passed to require chain pharmacies and mail-order pharmacies to participate in drug take back programs. But that bill was vetoed by the Governor. We believe that this legislation addresses the concerns that were raised last year by the Governor when he vetoed the bill.
Over the years, New York has developed product stewardship programs for electronic waste, rechargeable batteries, and mercury thermostats. There is no good reason to not extend this to the pharmaceutical industry.
An Important Step in Preventing Opioid Abuse
The removal of expired, unwanted, or unused medicines can be an important step in preventing opioid abuse. Indeed, it can save lives. This legislation would go a long way towards making the disposal of unused medications more routine. We applaud Senator Hannon and Assemblywoman Gunther for advancing this legislation and urge Governor Cuomo to sign it into law.
Thomas J. Madejski, MD
Legislature Completes Session with Public Health Victories
As reported last week, the NYS Legislature recently completed the scheduled portion of the 2018 Legislative Session. As noted below, working together with many specialty societies, various patient advocacy groups and other allies, the Session produced a number of public health victories for physicians and their patients. Moreover, hundreds upon hundreds of adverse pieces of legislation that would have added new mandates, new costs, and harmed patient access to needed care, were not enacted.
Among the measures adopted by the Legislature supported by MSSNY:
- Creating a statewide drug “take back” program for the safe disposal of medications,
- Requiring health insurers to provide data to the DFS for public reporting regarding their compliance with the mental health parity/substance abuse coverage requirements (MSSNY worked closely with the NYS Psychiatric Association on this)
- Expanded insurance coverage for prostate cancer screening without cost-sharing
- Prohibiting use of tanning facilities for those under 18 (MSSNY worked closely with the American Cancer Society on this)
- Provisions to extend MSSNY’s Committee for Physicians’ Health confidentiality and liability until 2023
- A new $100,000 grant (via a NYS Senate resolution) to provide physician education on women’s health issues.
Moreover, numerous adverse proposals that had been under serious consideration in the final weeks of Session were defeated or had objectionable provisions removed. Though there are far too many to list off here, some of the more notable proposals would have:
- Required physicians to report certain patients to the Department of Motor Vehicles (MSSNY worked closely with the Epilepsy Foundation and American Diabetes Association on this)
- Required physicians to inquire and document the school attended by their school age patients (MSSNY worked closely with HANYS, GNYHA and the NYC HHC on this)
- Expanded religious exemptions for otherwise required child immunizations (MSSNY worked closely with the NYS Academy of Family Physicians, NY-ACP and NY American Academy of Pediatrics on this).
- Expanded the scope of practice for naturopaths, podiatrists, dieticians, estheticians, psychologists and many other non-physicians (MSSNY worked closely with each of the affected specialties societies on this)
- Reduced the role of county medical societies in approving physicians to become authorized under Workers Compensation (MSSNY worked closely with county medical societies on this)
- Required physicians to co-prescribe naloxone for patients for whom an opioid medication is prescribed
- Reduced to 3 days the time frame for a physician to write an initial prescription for an opioid medication for a patient with acute pain
We thank all the physicians who took the time to communicate and/or visit with their legislators. With a few unfinished items (not related to health care) it is still possible for the Legislature to return to Albany later in the year where various bills effecting health care delivery could be brought up again.
MSSNY, AAP Raise Concerns with New Standardized Student Health Form
This week, representatives of MSSNY and the NYS American Academy of Pediatrics met with the NYS Education Department to raise concerns with the recently adopted New York State standardized student health assessment form that will be required to be used starting July 1. The physicians on the call, Dr. Gail Schoenfeld and Dr. Michael Terranova, raised concerns that the form is not easily compatible with physician EHR systems, creating unnecessary administrative burdens by forcing pediatricians and their staffs to manually input data into the new form.
In response, representatives from SED noted school districts have flexibility to use alternative forms in the short term, indicating that the school districts have been notified that, “to assist with the transition, during the 2018-2019 school year schools may accept any health examination form provided”. SED staff also indicated their interest in continuing the dialogue to find ways to reduce the administrative burden for physicians and their staff to complete the form.
CDC: Just 23 Percent of US Adults Meet Exercise Recommendations
While the nation has surpassed the Healthy People 2020 initiative goal of just over 20 percent of U.S. adults meeting exercise recommendations by 2020, shortfalls remain in some states and among certain demographics. According to the study results, New Yorkers need to exercise more.
NYeC (NYehealth Collaborative) News: Statewide Patient Care Alerts
The NY Ehealth Collaborative recently announced the statewide expansion of patient care alerts through the Statewide Health Information Network for New York (SHIN-NY). This allows SHIN-NY participants to receive updates on their patients, regardless of where in the state care was received.
Lyme Disease Cases Significantly Underreported, CDC Says
The Wall Street Journal (6/22) reported that disparities between documented Lyme disease cases and the actual prevalence are high, according to the CDC, which says that the 30,000 cases recorded annually are a fraction of the probable 300,000 cases per year. Lyme disease, as the “most common vector-borne disease by far,” remains “underreported,” according to CDC epidemiologist Dr. Kiersten Kugeler. She added, “All reportable diseases are subject to underreporting, although we know this is particularly true for common diseases and for those often treated in an outpatient setting.”
Flu Control Pill Being Fast Tracked by FDA
A pill that helps control flu symptoms after one dose is getting fast consideration from the Food and Drug Administration, the company that makes it said Tuesday. Genentech said the FDA had granted priority review to baloxavir marboxil and would decide whether to approve it by the end of this year. If approved, baloxavir would be the first new flu drug to hit the U.S. market in years and the first with a new mechanism of action in 20 years.
“Baloxavir marboxil has been shown in clinical trials to decrease the duration of symptoms with one dose, and demonstrated a significant reduction in viral shedding in just one day,” said Dr. Sandra Horning, chief medical officer at Roche, which owns Genentech.
Influenza viruses developed resistance long ago to the first two antiviral flu drugs, amantadine and rimantadine. Newer antiviral drugs on the market include Tamiflu, a pill; Relenza, which can be inhaled; and an injectable drug called peramivir.
“The FDA is expected to make a decision on approval by December 24, 2018,” the company said.
New Shingles Vaccine in Short Supply
On Oct. 25, the CDC recommended Shingrix as the preferred vaccine for the prevention of shingles for adults aged 50 and up. The Washington Post (6/20) “To Your Health” blog reports there is a national shortage of the new shingles vaccine Shingrix, “prompting retailers to create waiting lists and the manufacturer to delay additional promotion.” The CDC now recommends Shringrix over Zostavax for people over the age of 50.
FDA Approves Chemical in Marijuana to Treat Seizures
A chemical derived from marijuana has become the first of its kind to be approved by the Food and Drug Administration and will be delivered to patients suffering from epilepsy in the form of a strawberry-flavored syrup.
The FDA announced Monday that it had approved the drug, cannabidiol, which is one of 80 active chemicals in marijuana, to treat seizures from epilepsy. It is the first time the agency has approved a purified drug substance that comes from marijuana. The drug, which is formally known as Epidiolex, will be allowed to be prescribed to infants as young as age 2 for Lennox-Gastaut syndrome and Dravet syndrome, two rare and severe forms of epilepsy. It is made by GW Pharmaceuticals, a company based in the United Kingdom.
Nominations Open for 2018 Albion O. Bernstein, MD, Award
The Medical Society of the State of New York is accepting nominations for the 2017 Albion O. Bernstein, MD Award. This prestigious award is given to: “…the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2017.”
This award was endowed by the late Morris J. Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in November, 1940.
The $2,000 award will be presented to the recipient during a MSSNY Council Meeting. Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.
To request an application, please contact: Committee on Continuing Medical Education, Miriam Hardin, PhD, Manager, Continuing Medical Education, Medical Society of the State of New York, 99 Washington Avenue, Suite 408, Albany, NY 12210 or call 518-465-8085 or email email@example.com. +
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MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
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