The NC Controlled Substances Reporting System (NCCSRS) recently mailed letters alerting prescribers in the state that they have authorized prescriptions to a patient who is receiving controlled substances from multiple prescribers or may be engaged in “doctor shopping”.
Nearly 900 prescribers received letters from NCCSRS in October. To receive a letter, the prescriber must have written a prescription for a controlled substance to a patient who received controlled substances prescriptions from a total of seven different prescribers AND obtained medications from seven different pharmacies over a 90 day period. The October letters pertained to prescription activity by approximately 90 patients (e.g. each patient saw at least seven prescribers AND obtained medications from at least seven pharmacies during a three month period).
The alert letters are intended to raise prescriber awareness of potentially unsafe activity by patients in their care, and to encourage greater licensee use of the state’s CSRS. NCCSRS is a statewide database of all controlled substances dispensed in outpatient settings. All prescribers authorized to write controlled substances prescriptions are encouraged to register for access and regularly use the system to assess their patients’ controlled substances use. The NCCSRS may also be used by a prescriber to self-audit their own prescribing. A recent review by CSRS administrators found that less than half of prescribers with a valid DEA registration are currently registered to access their patients’ prescription histories.
Alert letter recipients are invited to view the prescription history report for the patient or patients in question by logging in to the CSRS system. If the prescriber is not currently registered, he or she is encouraged to do so. NCMB licensees may register here
The letters acknowledge that some patients may have legitimate medical needs that call for significant amounts of controlled substances to be prescribed. Reviewing the patient’s prescription history and your prescribing to those patients is a prudent step to guard against misuse and abuse, and may present an opportunity to intervene, if needed.