Resources & Information

The STOP Act mandates that all prescriptions for targeted controlled substances – a designation that includes all Schedule II and Schedule III opioids and narcotics – that are issued on or after Jan. 1, 2020, be e-prescribed.

All “targeted controlled substances” – a category created by the STOP Act – must be e-prescribed, effective Jan. 1, 2020. All Schedule II and Schedule III opioids and narcotics are in this group. A complete list can be found here.

The law specifies the following exemptions:

1. A practitioner, other than a pharmacist, who dispenses directly to an ultimate user.
2. A practitioner who orders a controlled substance to be administered in a hospital, nursing home, hospice facility, outpatient dialysis facility, or residential care facility
3. A practitioner who experiences temporary technological or electrical failure or other extenuating circumstance that prevents the prescription from being transmitted electronically; provided, however, that the practitioner documents the reason for this exception in the patient’s medical record.
4. A practitioner who writes a prescription to be dispensed by a pharmacy located on federal property; provided, however, that the practitioner documents the reason for this exception in the patient’s medical record.
5. A person licensed to practice veterinary medicine.

No. Choosing not to develop e-prescribing capability, whatever the reason, does not qualify as an “extenuating circumstance” in the Board’s view and would not exempt a licensee from the STOP Act e-prescribing requirement.

No, the Board would not consider this an acceptable practice. Directing established patients to a hospital emergency room or other medical provider for treatment could constitute patient abandonment, depending on the circumstances. Licensees are strongly encouraged to develop e-prescribing capability if they will continue to prescribe Schedule II and Schedule III opioids and narcotics after Jan. 1, 2020.

The STOP Act specifically exempts pharmacies and pharmacists from having to determine whether individual prescriptions are valid or comply with the e-prescribing mandate, and states at § 90-106 (a2), “A dispenser may continue to dispense targeted controlled substances from valid written, oral, or facsimile prescriptions that are otherwise consistent with applicable laws.” Therefore, if presented with a paper prescription for a targeted controlled substance after Jan. 1, 2020, a pharmacy may lawfully fill it. Per the NC Board of Pharmacy, repeated instances of noncompliance (e.g. continued use of paper prescriptions for Schedule II and Schedule III opioids and narcotics) could lead a pharmacist to address the issue. This could include reaching out to the prescriber to ensure he or she is aware of the e-prescribing mandate. Alternatively, pharmacists could report prescribers who persist in writing paper prescriptions to NCMB, which would investigate.

There is no specific consequence established by the STOP Act. NCMB would evaluate each situation and determine an appropriate resolution based on the individual circumstances of each case.

The Board cannot provide specific advice or recommendations to its licensees. Prescribers who do not currently have e-prescribing capability are strongly encouraged to identify an e-prescribing solution that complies with the law. Commercial products, such as an e-prescribing app for your smartphone or standalone e-prescribing software, may be an option (provided the product selected meets applicable privacy and security standards). Again, NCMB cannot recommend specific vendors or products.

Professional and specialty organizations (NC Medical Society, Old North State Medical Society, NC Academy of Family Physicians, NC Academy of Physician Assistants, NC Osteopathic Medical Association, etc.) may be able to offer additional information or guidance.

The prescriber or a member of the practice support staff can contact the pharmacy to ask them to cancel the prescription. Then, the prescriber may reissue the prescription to another pharmacy.

Yes. To provide multiple one-month prescriptions to a patient, the prescriber may issue a separate e-prescription for each month and indicate a “do not fill” until date on each prescription to indicate the appropriate fill date.