NC Medical Board Refines Safe Opioid Prescribing Initiative Criteria

The North Carolina Medical Board (NCMB) voted last month to refine how they determine who will be investigated under their Safe Opioid Prescribing Initiative (SOPI). Read the proposed rule changes here. The Board will accept comments on the proposed changes through May 1. Please email comments to A public hearing on the changes will be held at 10 a.m. on May 1.

According to the US Centers for Disease Control and Prevention (CDC) and the North Carolina Center for Health Statistics, there are 97 opioid prescriptions for every 100 North Carolina residents, and opioid overdose deaths are up in the state by 32 percent over the past decade. Faced with this prescription opioid crisis in North Carolina, the NCMB launched its Safe Opioid Prescribing Initiative in April 2016.

The initiative is designed as a method of protective oversight with the NCMB investigating licensees who prescribe large numbers of high dose opioids and who have had two or more patients die of opioid overdose within a 12-month period. Meeting the criteria for investigation is not evidence of wrongdoing, simply the threshold by which the NCMB may begin an investigation. Since the initiative launched nearly a year ago, 22 percent of the cases investigated resulted in public adverse action, 33 percent resulted in a private action and 44 percent of the cases were closed with no formal action.

Also at its January meeting, the Board voted to adopt the CDC Guidelines for Prescribing Opioids for Chronic Pain, which was developed in 2016. The NCMB firmly states its primary goal is to prevent inappropriate prescribing, not to disrupt the treatment of patients with a legitimate need for pain management.

Please review the CDC guidelines and the NCMB’s position statement. Learn more about the Board’s SOPI.

You may also be interested in data collected by the NC Department of Health and Human Services including usage by county of the Controlled Substance Reporting System (CSRS) and opioid prescriptions by county. Access that data.

Legislators, too, are looking at ways to address the opioid abuse epidemic in our state. The North Carolina Medical Society (NCMS) anticipates bills will be introduced this session seeking to regulate how you prescribe opioids. Watch your NCMS Bulletin and our weekly Bowtie Briefing video and Legislative Update blog posts for details.


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  • kerry willis

    I couldn’t help but look at Carteret County and see how high we are compared to the rest of the state. I am aware that the prescriptions for many of the residents being prescribed narcotics do not originate with physicians in Carteret County but in the many pain clinics in the counties that surround us. Without the local knowledge of that fact, you wouldn’t know of the county efforts to lower and reduce diversion that have been very successful with county physicians.
    I do have concerns with starting fishing expeditions through practices based on suspicions and thoughts and perhaps careful review of this process is warrented.

    • kerry willis

      Adding to my thoughts…

      Perhaps what we should have the NCMB develop is suggested best practices for initiating and treating patients with chronic pain. Physicians within the best practices should have to worry about investigation and would eliminate bias depending on practice location and access to care issues that create highly variable statistics.