SUBJECT:

PURPOSE:

NYS Assembly Hearing Room
Room 1923
250 Broadway
New York, New York
Friday, January 13, 2006
10:00 AM

Prescription medications provide invaluable relief to countless people with health problems, and when taken appropriately can improve the quality and length of life.

Regrettably, the nonmedical use or abuse of prescription drugs is a serious and growing public health problem in this country, especially among young people and the elderly. Recent surveys indicate that millions of Americans are addicted to prescription drugs. Many of these addicts are average citizens, with no prior history of drug abuse, who became "hooked" after first using the drugs for legitimate medical reasons. For many, drug usage escalates until they cannot stop; and, left unchecked, the destructive course of addiction can ruin lives and tear families apart.

One of the most troubling factors related to prescription drug abuse is that many people believe that prescription medications are safer than illegal "street" drugs because they are prescribed by a doctor, approved by the federal Food and Drug Administration, "clean" (not mixed with other substances), and "non-addictive."

A disturbing trend is that many young people have found that some of the easiest drugs to get their hands on are right in their own homes - prescription medications used by members of their own family.

According to the National Institute of Drug Abuse, prescription drug abuse is not limited to younger people. Many senior citizens abuse or are addicted to prescription drugs. Persons 65 years of age and above comprise only 13 percent of the population, yet account for approximately one-third of all medications prescribed in the United States. Older patients are more likely to be prescribed long-term and multiple prescriptions, which could lead to unintentional misuse, abuse or addiction.

Also, the growth of the internet has facilitated prescription drug abuse. While most online pharmacies are reputable businesses that provide an essential service, there are large and growing numbers of web-based pharmacies that sell medications of dubious quality, without prescriptions, to anyone who is willing to pay.

The New York State Assembly Standing Committee on Alcoholism and Drug Abuse and the New York State Assembly Standing Committee on Health are seeking testimony from knowledgeable witnesses for the purpose of learning what New York should do to more effectively prevent prescription drug abuse and addiction, assessing the needs of persons who abuse prescription drugs, ascertaining if the services available to such persons meet those needs and determining if New York State needs to take action to improve prevention and services. WITNESSES SHOULD BE PREPARED TO SUGGEST AND DISCUSS SPECIFIC MEANS BY WHICH THE STATE MIGHT DIRECTLY ADDRESS THE PROBLEMS OF PRESCRIPTION DRUG ABUSE.

Please see the list of subjects to which witnesses may direct their testimony.

Persons wishing to present pertinent testimony to the Committee at the above hearing should complete and return the reply form as soon as possible. It is important that the reply form be fully completed and returned so that persons may be notified in the event of emergency postponement or cancellation.

Oral testimony will be limited to 5 minutes' duration. Testimony will be under oath. In preparing the order of witnesses, the Committee will attempt to accommodate individual requests to speak at particular times in view of special circumstances. These requests should be made on the reply form below or communicated to Committee staff as early as possible. In the absence of a request, witnesses will be scheduled in the order in which reply forms are postmarked.

Ten copies of any prepared testimony should be submitted at the hearing registration desk. The Committee would appreciate advance receipt of prepared statements.

In order to further publicize these hearings, please inform interested parties and organizations of the Committee's interest in hearing testimony from all sources.

In order to meet the needs of those who may have a disability, the Assembly, in accordance with its policy of non-discrimination on the basis of disability, as well as the 1990 Americans with Disabilities Act (ADA), has made its facilities and services available to all individuals with disabilities. For individuals with disabilities, accommodations will be provided, upon reasonable request, to afford such individuals access and admission to Assembly facilities and activities.

SELECTED ISSUES TO WHICH WITNESSES MAY DIRECT THEIR TESTIMONY:

1. What is the nature and magnitude of prescription drug abuse in New York State? What are the demographics of populations abusing various classes of prescription drugs?

2. What factors have influenced trends in abuse of prescription drugs? For instance, what role have changes in the health care system, prescribing practices, and prescription medication accessibility (such as via the internet) played in the growth of prescription drug abuse?

3. Is there adequate training of health care providers regarding the prescribing of medications, particularly to youth and the elderly, with the potential for abuse? Are particular prevention strategies used to address at-risk groups?

4. What types of prescription abuse are common among youth? For example, how prevalent is: 1) the mixing of prescription drugs with other drugs of abuse that place youth at risk for drug interactions and overdose; 2) the misuse and abuse of prescribed stimulants, and the sharing of these prescribed drugs with peers; and 3) the use of stimulants on college campuses for appetite suppression, wakefulness, increased attention, and euphoria?

5. What types of prescription abuse are common among the elderly? Are prescription drugs being abused for common ailments, which impact the elderly, such as chronic pain, insomnia, or depression?

6. Does prolonged treatment with prescription psychoactive drugs for conditions, including ADD/ADHD, insomnia, pain, obesity, and anxiety disorders, contribute to drug abuse or relapse to drug abuse in vulnerable individuals? What is the proper clinical response?

7. Does noncompliance with prescription drug dosing increase the likelihood of transition from legitimate use to addiction? Is noncompliance more likely in particular segments of the population?

8. Are existing drug abuse prevention approaches effective against prescription drug abuse? How could prevention efforts be improved or expanded?

9. Are there effective therapies for individuals who abuse prescription drugs and have co-occurring mental disorders, such as depression, anxiety disorders, post-traumatic stress disorder, and eating disorders or co-morbid physical disorders such HIV/AIDS or musculoskeletal disease associated with chronic pain?

10. How effective is the use of medications in the treatment of prescription drug abuse, such as the use of buprenorphine for oxycodone abuse?

11. How can the screening, assessment, and recognition of prescription drug abuse and dependence among patients being treated in health care settings for medical and/or psychiatric illnesses, especially those which are chronic in nature, be improved?

12. What can be done to promote the effective dissemination of science-based information on the recognition, prevention, and treatment of prescription drug abuse to health professionals and community-based health care providers?

PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on combating the "silent epidemic" of prescription drug abuse are requested to complete this reply form as soon as possible and mail it to:

Bill Eggler
Senior Legislative Analyst
Assembly Committee on Alcoholism and Drug Abuse
Room 522 - Capitol
Albany, NY 12248
Email: egglerw@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693

I will address my remarks to the following subjects:

I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required: