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How did a Nassau County doctor overprescribe highly addictive pain pills, despite strict laws in place?

Team 12 Investigates uncovered that pharmacies are not mandated to inform the state in this situation, which allowed Nelson to continue illegally prescribing oxycodone.

Rachel Yonkunas

May 18, 2024, 12:14 AM

Updated 36 days ago

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Many are questioning how a Nassau County doctor got away with overprescribing highly addictive pain pills, despite strict laws in place.
Alan Nelson, of East Norwich, was forced to end his nearly 50-year career as a doctor after pleading guilty to unlawfully distributing oxycodone.
Federal prosecutors said Nelson was prescribing oxycodone to such an extent that, in 2020, Rite Aid pharmacy questioned some of Nelson's patients and determined that he was overprescribing controlled substances to them.
Rite Aid then sent a letter to Nelson stating that it would “no longer fill prescriptions from your office for Schedule II, III, IV and V controlled substances” because of their concern about increased reports of prescription drug abuse, especially oxycodone, according to court documents.
Team 12 Investigates uncovered that pharmacies are not mandated to inform the state in this situation, which allowed Nelson to continue illegally prescribing oxycodone.
The ex-doctor admitted to prescribing 92,700 milligrams of oxycodone to a single patient for no legitimate medical purpose between 2020 and 2021. Federal prosecutors believe he unlawfully provided opioids to at least 14 other patients.
New York’s I-STOP Act is meant to prevent overprescribing. It was passed in response to the deadly Medford pharmacy murders in 2011.
The act requires doctors to electronically prescribe controlled substances to help them keep track of a patient’s drug history, evaluate their patients' treatment with controlled substances and determine whether there may be abuse or non-medical use. Pharmacies also have access to the I-STOP database.
Addiction specialist, Dr. Jeffrey Reynolds, said the system is not foolproof, but there are changes that will catch the state’s attention.
“If a prescriber's pattern changed dramatically, there are folks from the state health department that come out and have a conversation and say did your population change, did your practice change,” said Dr. Reynolds. “Technology isn’t always perfect. People aren’t always perfect so we’re not 100%.”
Nelson's defense attorney said Nelson did not carefully keep track of the number and quantity of opioids he prescribed. Nelson was not motivated by greed, according to court documents, rather he was “driven by a desire to please his patients and to ignore and avoid difficult conversations around misuse of opioids."
Treatment advocates, though, said those are the conversations that can save lives.
“Quite frankly, addiction is killing more people in the United States than most other diseases combined,” Dr. Reynolds said. “If your doctor is not talking to you about this, then what?”
If you or someone you know is struggling with addiction, the Family & Children’s Association has resources and support teams available to help.


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