Opioid prescribing and abuse prevention continue to be discussed by policymakers at both the national and state levels. The NCMS has been involved through a special task force and our lobbying efforts. At our last two Annual Meetings, the topic was addressed by NC Attorney General Roy Cooper (at the 2012 Annual Meeting) and the topic of the “Scope of Pain: Safe and Competent Opioid Prescribing Education” CME at the 2013 meeting.
Overview of the Epidemic
Legislation to Combat Abuse
Read the proposed federal Prescription Drug Abuse Prevention and Treatment Act of 2013, House Bill 672:
The AMA is working at the national level highlighting the need for additional support for addiction treatment and prevention of overdose and death. This includes support for legislation that increases access to naloxone – an opioid antagonist – that can help prevent death from overdose if administered in a timely manner. The AMA has provided resources to numerous medical societies, and provided direct support to at least three bills that have become law. Read the AMA’s Issue Brief on the topic here:
More than 35 states are considering legislation in response to this epidemic. In North Carolina, passage of Senate Bill 222/House Bill 173 during the 2013 Legislative Session meant revisions to portions of the Controlled Substance Reporting System (CSRS). Including:
- Shortens the mandatory reporting window for pharmacies from seven days to three business days.
- Dispensing physicians are now required to report into the system as pharmacies do.
- Dispensers and pharmacies must now record the method of payment used by the purchaser.
- Reporting is not required for prescriptions provided directly to the user if the supply does not exceed a 48 hour dosage.
- The Department of Health and Human Services may notify practitioners if one of their patients is suspected of doctor shopping.
- The Department of Health and Human Services may notify a licensee’s regulatory board (for example, the North Carolina Medical Board) of potentially improper prescribing patterns, but only after the regulatory board adopts rules to set criteria for receiving such information.
- Physicians may now delegate someone else in their office to access the CSRS system in order to improve the likelihood of patient screening. DHHS is currently in the process of developing this technical capability; it is expected to be in place by January 2014.
- This bill does NOT allow Sheriffs to access the system without a lawful court order. However, the Attorney General may refer investigations to Sheriffs.
- This bill does NOT require physicians to access the CSRS prior to prescribing a controlled substance.
NC Medical Board’s position statement on controlled substances
For a comprehensive review all of the bills pertaining to the CSRS and opioid prescribing and abuse prevention see the NCMS 2013 Legislative Summary beginning on page 14.