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Aug 14 2009

CSRS Data for NC: What they can tell us; what they can’t

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So far, the North Carolina Controlled Substances Reporting System (CSRS) is a gold mine of information on how many and what kinds of prescriptions for controlled substances (CS) are dispensed statewide. In 2008, more than 16 million (16,167,781) CS prescriptions were written and dispensed in our state. More than 5 million (5,297,074) individual patients were recorded as having been dispensed a prescription. Schedule III drugs were most often prescribed to patients (37.0%), followed by prescriptions for Schedule IV drugs (29%), Schedule II drugs (27.4%) and Schedule V drugs (6.5%).

Data for 2008 also show that dispensing rates varied widely by month and by county. The lowest number of CS prescriptions was dispensed in June (1,126,903) and the highest numbers were dispensed in October (1,489,801) and December (1,477,139). The state CS prescription rate in 2008 was 17,878 scripts per 10,000 persons or 1.7 prescriptions per person in a state of more than nine million residents. Most of the counties with the highest prescription rates were in western NC. In descending order of rank, the top 10 prescribing counties were Columbus, Wilkes, Stokes, Richmond, Carteret, Martin, Gaston, Burke, Bladen and Cherokee. There was greater geographic (and socioeconomic) diversity among the counties with the lowest prescription rates. The top 10 lowest prescribing counties included two of the state's most urban counties (Durham and Mecklenburg) as well as some of the state's most rural eastern counties (Pasquotank, Hyde, and Currituck).

Three-quarters (74.5 percent) of the CS prescriptions dispensed in North Carolina were for narcotic analgesics (45.4%), tranquilizers (17.8%) and sedatives (11.3%). The remaining quarter (25.5%) were for anticonvulsants, amphetamines, central nervous system stimulants, colds and coughs and other miscellaneous controlled substances.

What these data cannot tell us is whether these variations reflect 'good' or 'appropriate' prescribing profiles to treat the illnesses of the people of North Carolina or whether or not medical practitioners are using these data as a tool to help determine when or what controlled substances should be prescribed to their patients. The reporting system is young. More medical care providers need to use it, and more need to interpret its findings.

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