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New York State Oce of the State Comptroller
Thomas P. DiNapoliDivision of State Government Accountability
Report 2011-S-19November 2012
Selected Operang andAdministrave Pracces of theBureau of Narcoc EnforcementDepartment of Health
Division of State Government Accountability
Execuve Summary
To determine whether the Bureau of Narcoc Enforcement (Bureau) is eecvely and ecientlycombang prescripon drug diversion and abuse in New York State. The audit covers the periodApril 1, 2007 through March 8, 2012.
Illegal use of prescripon drugs is an escalang problem that drives up healthcare costs andthreatens the safety of all cizens. So great is the problem that the Centers for Disease Controland Prevenon has classied abuse and diversion of prescripon drugs as an epidemic and thenaon’s fastest growing drug problem. The underground market for these drugs is fueled inlarge part by individuals and criminal groups who use fraudulent taccs to acquire powerful andaddicve medicaons, including painkillers like Oxycodone, Fentanyl or Morphine; smulantslike amphetamines or Ritalin; and hypnoc drugs and sleep aids like Ambien. The Bureau isresponsible for combang these illegal acvies by overseeing the State’s Ocial PrescriponProgram and invesgang suspected cases of drug diversion and abuse. To this end, it maintainsa database of all New York State prescripons used to acquire controlled substances.
Key Findings
The Bureau has a signicant amount of informaon and resources at its disposal to combat illegaldrug acvity. Our audit idened several areas where improvements are needed to ensure theseresources are used eecvely to stem the growing problem of prescripon drug diversion andabuse through a range of eorts from prevenon and deterrence, to detecon and prosecuon.• By applying data mining techniques to 15 months of the Bureau’s prescripon data, we culledmore than 565,000 lled prescripons that contained errors or inconsistencies. These include67,000 prescripons for drugs like Oxycodone, each potenally used mulple mes for a totalof almost 180,000 transacons at dierent pharmacies and/or containing dierent informaonabout the prescribers or the drugs involved. While we recognize further assessment andrenement of the data is needed, analyses like this can pinpoint paerns and relaonships thatidenfy criminal acvity.The Bureau does not always properly secure or monitor returned prescripon forms. As a result,
data shows thousands of unused forms, supposedly destroyed, may actually have been used toobtain controlled substances.
• The Bureau’s previous management failed to establish consistent invesgave priories amongits regional oces, making the Bureau less eecve in detecng and ceasing criminal conduct.• Some Bureau funding was used for other acvies or should have been used more eciently,including over $43,000 of computer equipment purchased several years ago, the majority of which was sll not in use by the end of 2011.During our audit, we provided Department ocials with preliminary ndings detailing ourobservaons and recommendaons. At the conclusion of our eldwork and shortly thereaer,the Department announced several changes to Bureau operaons including installaon of newleadership, implementaon of new data mining strategies and plans to eliminate the paper-based
Division of State Government Accountability
prescripon system for controlled substances. These posive steps should help address severalof the challenges discussed in this report. However, further improvements are sll needed tomaximize the Bureau’s ability to combat the growing problem of prescripon drug diversion and
Key Recommendaons
• Further review the prescripon data idened by our audit to isolate instances and paernsthat warrant formal invesgaon.• Modernize the Bureau’s use of technology and informaon resources by expanding roune dataanalysis to assist in more eecvely idenfying and invesgang prescripon drug diversion
and abuse.
• Properly account for, safeguard and monitor the destrucon or other disposion of prescripon
forms returned to both the Bureau and its contracted supplier.
• Establish and communicate clearly dened and consistent priories, objecves and goals toguide regional invesgaons. Monitor outcomes to determine whether invesgators andoces are meeng expectaons.• Monitor and reconcile expenditures to ensure that funding is used as intended.In responding to our dra report, ocials acknowledge both the value of data mining and analysis,and that their own subsequent tesng has shown some of the records we cited were relatedto specic instances of suspected criminal acvity. Ocials also reported they plan to expandthe Bureau’s analycal sta to conduct more in-depth analysis to address diversion. Ocialsalso reported acons taken to beer account for returned prescripon forms, oversee statewideinvesgave acvies, correct previously idened problems, and control the use of Bureaufunding. At the same me, the Department’s response also includes several statements thatminimize the signicance of the ndings from our analysis of prescripon data.Auditor CommentWhen looking for fraud and abuse, ocials should expect that only a very small percentage of transacons will be problems and specic tools, like data mining and analysis, are necessary tohighlight the ones that pose the highest risk. Considering the vast number of prescripons lledfor these controlled substances, we cauon that ocials should not be too quick to dismiss theimpact of even a small percentage of problems; especially when only one-half of one percent couldtranslate into 100,000 instances each year where dangerous drugs are dispensed improperly. Ourspecic rejoinders to some of the Department’s statements are presented as State Comptroller’sComments at the end of this report.
Other Related Audits/Reports of Interest

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