Prescription Drug Abuse Prevention

The U.S. Centers for Disease Control and Prevention has classified prescription drug abuse as an epidemic. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time began by using a prescription drug non-medically.

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, our lobbying efforts, and educational outreach to prescribers.

 

2016 Legislation to Combat Abuse

2016 APPROPRIATIONS ACT – CSRS UPGRADES AND PRESCRIBER REGISTRATION
HB 1030 / S.L. 2016-94
NCMS has long supported the state’s Controlled Substance Monitoring System (CSRS) as a tool to inform physician prescribing of controlled substances. In 2016 the General Assembly tucked some important, positive changes to the CSRS into its annual budget bill. An oft-cited shortcoming with the CSRS is its lack of integration with other registries, databases and health information technology. The General Assembly squarely confronted this problem; in an attempt “to improve the security, functionality and interface capabilities” of the CSRS, the 2016 budget allocated $600,000 to upgrade the CSRS so it may connect to other state prescription drug monitoring systems and the NC Health Information Exchange. A separate appropriation of over $1 million also was made to improve analytics of the prescription drug data reported to the CSRS.

The General Assembly also was motivated to address the low rates of CSRS registration and usage by prescribers. As in years past, multiple proposals were made to require prescribers to not only register with the CSRS, but also to check a patient’s prescription drug history prior to writing a prescription for a controlled substance. One such proposal even threatened prescribers with misdemeanor or felony charges for not consulting the CSRS. (NCMS opposed this particular proposal and worked to prevent its passage.) What did eventually pass in 2016 is a requirement that physicians and all other prescribers register to use the CSRS. While a mandate to check the CSRS also was close to passage, it was dropped late in the session at the request of NCMS, NC College of Emergency Physicians, the NC Society of Anesthesiology, NC Pediatric Society and others. To enforce the new registration mandate, the North Carolina Medical Board will require each physician and PA to attest to CSRS registration upon the renewal of the individual’s license. This attestation must occur within 30 days of the renewal. The Board may suspend or revoke a license if a licensee fails to register with the CSRS and/or fails to make the attestation. Learn more on the North Carolina Medical Board’s website.

STATEWIDE STANDING ORDER FOR NALOXONE
SB 734/ S.L. 2016-17
As part of the response to the opioid epidemic plaguing communities across the state, and with support from the North Carolina Medical Society, the legislature swiftly passed Senate Bill 734. This bill specifically authorizes the State Health Director to issue a statewide standing order for the dispensing of the drug, Naloxone, which can reverse the effects of opioid-related overdose. Under the standing order, pharmacists may dispense Naloxone directly to individuals who meet any of the enumerated criteria. No prescription from a physician is required for either the intranasal or intramuscular/injectable applications. When Governor Pat McCrory signed SB 734 into law on June 20, 2016, State Health Director Randall Williams, MD, simultaneously issued the standing order. North Carolina became the third state in the country to implement a statewide standing order in an attempt to make the drug more accessible to those at risk of opioid overdose. For more information about Naloxone and North Carolina’s standing order, please visit www.naloxonesaves.org.

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