Purpose

To determine the extent of implementation of the five recommendations included in our initial audit report, Selected Operating and Administrative Practices at the Bureau of Narcotic Enforcement (Report 2011-S-19).

Background

Our initial audit report, issued November 21, 2012, examined whether the Bureau of Narcotic Enforcement (Bureau) was effectively and efficiently combating prescription drug diversion and abuse in New York State, in large part through its analysis and use of prescription data that it maintains electronically. We found several areas where the Bureau could improve its ability to ensure its resources are used effectively to stem drug diversion and abuse through a range of efforts, from prevention and deterrence to detection and prosecution. For example, our analysis of prescription data identified patterns of errors or inconsistencies affecting more than 325,000 prescriptions filled over 565,000 times for controlled substances such as Oxycodone (OxyContin), Hydrocodone (Vicodin), and Zolpidem (Ambien).

The initial report included five recommendations: to review the identified prescriptions for potential investigations; enhance routine data analysis; safeguard returned prescription forms; develop and communicate investigative priorities, goals, and objectives; and reconcile Bureau funding. Subsequent to our original audit, the Legislature approved the new Internet System to Track Over-Prescribing (I-STOP), which, among other provisions, made additional data available while requiring real-time submission prescription information within 24 hours of substance delivery.

Key Findings

• Throughout our examination, Department officials were substantially less than forthcoming in responding to our requests for information. We initiated this review in November 2014 and despite multiple and frequent requests, six months elapsed before we received any substantive information from the Department, the bulk of which was not provided until June and July 2015. In addition, some of the information that we requested has still not been provided.
• Overall, by implementing I-STOP, the Department has made progress in enhancing its electronic prescription data and in some of the routine analyses that it performs using this data. It has also improved security and accountability over blank prescription forms returned to its office and to its suppliers. However, improvements are still needed in several important areas.
• Of the five prior audit recommendations, two were fully implemented, two were partially implemented, and one was not been implemented.

Key Recommendation

Officials are given 30 days after the issuance of the follow up review to provide information on any actions that are planned to address the unresolved issues discussed in this report.

Other Related Audit/Report of Interest

Department of Health: Selected Operating and Administrative Practices of the Bureau of Narcotic Enforcement (2011-S-19)