Resources & Information

Feb 26 2021

Mandatory use of NC CSRS: It’s imminent

Comments:   2 comments  Print Friendly Version  |   Share this item
NCMB said it would keep licensees in the loop and we are making good on that promise.

A STOP Act requirement to check the NC Controlled Substances Reporting System (NC CSRS) before prescribing certain controlled substances is on the brink of taking effect. NCMB has been notified by the NC Department of Health and Human Services' Drug Control Unit - which runs NC CSRS - that all system upgrades and requirements that, by law, must be completed before the requirement can be in effect have been finished.

Although there is still no specific effective date for mandatory NC CSRS use, it's clear that it won't be long now. It's time to register, if you haven't yet.

So what are the specific requirements of the law? A summary is provided below. Or, review the relevant statute, §90-113.74C (a).

Prior to prescribing a Schedule II and Schedule III opioid or narcotic, practitioners are required to review a patient’s 12-month prescription history in the NC CSRS. For every subsequent three-month period that the Schedule II or Schedule III opioid or narcotic remains part of the patient’s medical care, practitioners are required to review the patient’s 12-month history in the NC CSRS.

Reviews should be documented within the patient’s medical record along with any electrical or technological failure that prevents such review. Practitioners are required to review the history and document the review once the electrical or technological failure has resolved.

Certain practitioners may, but are not required to, review the NC CSRS prior to prescribing a targeted controlled substance to a patient in any of the following circumstances:

• Controlled substances administered in a health care setting, hospital, nursing home, outpatient dialysis facility or residential care facility.

• Controlled substances prescribed for the treatment of cancer or another condition associated with cancer.

• Controlled substances prescribed to patients in hospice care or palliative care.

The STOP Act authorizes NC CSRS to conduct periodic audits to determine prescriber compliance with review requirements. The law states that NC CSRS shall report to the Board any licensee found to be in violation of the requirement to check NC CSRS; violations may result in regulatory action by the Board.

 Comments on this article:

I’m certain this will be time well-spent when prescribing for children (or adults for that matter) with obvious significant, acute musculoskeletal injuries.  The universality of this requirement is absurd, and furthermore, it is an inappropriate legislative intrusion upon the exercise of good professional judgment and clinical decision-making.  “One-size” never fits all. 

At least it will have accomplished its primary goal—the legislators and our governor were able to beat their chests and proclaim that they “did SOMETHING” about the opioid crisis.  Meanwhile here, back at the ranch, I’m draining as many heroin abscesses on-call as ever.

By David Thompson on Feb 28, 2021 at 8:39am

In the ED setting providers can put together a pt’s presentation, allergy profile, and visit history (especially with current EMRs available in many institutions) and get a decent idea of whether a NC database search is warranted for a particular patient.  Enforcing a DB search for every patient is not necessary or wise and will be one more thing that takes time away from patient care in the name of stopping the opioid epidemic.  Making the CS database widely available, integrating it into EMRs, etc is useful and effective.  Mandating a search for each controlled substance prescribed is not. 

By William Enslow on Mar 04, 2021 at 6:31pm
 Post a comment on this article
Please do not include links to external websites in your comment. Please limit comments to no more than 300 words. The NCMB reserves the right to edit comments to meet the length limit. Abusive or profane remarks and personal attacks will not be published. The editor will make every effort to review and post comments in a timely fashion.