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The North Carolina Medical Board recently released a new mandate for the Strengthen Opioid Misuse Prevention (STOP) Act of 2017. Starting in January, North Carolina agencies prescribing opioids and narcotics will be required to submit prescriptions electronically. This e-prescribe requirement is for targeted controlled substances, which include Schedule II and Schedule III opioids and narcotics. Targeted controlled substances is a category originally created by the STOP Act in 2017. The NC Medical Board created a complete list of substances requiring electronic prescriptions.

What is the STOP Act?

Signed by Gov. Roy Cooper in 2017, the STOP Act was intended to address the opioid crisis in North Carolina. The state hoped this act would reduce excessive and inappropriate opioid prescribing. Primary components of the STOP Act include prescribing limits and requirements for the NC Controlled Substances Reporting System (CSRS). Other provisions mandated in the act impact licensed professionals who prescribe controlled substances. For example, Physician Assistants and Nurse Practitioners must consult with a superior physician before prescribing a targeted controlled substance.

Statistics of Opioid Use in North Carolina

In order to understand the STOP Act, the opioid crisis in North Carolina must also be understood. According to the North Carolina Department of Health and Human Services, here are some statistics on the issue:

• 445,002,000 opioid pills were dispensed to North Carolina residents in 2018
• 1,718 NC residents died from an unintentional opioid overdose in 2018
• 5 North Carolinians died each day in 2018 from unintentional opioid overdose
• More than 14,500 people in NC died because of an unintentional opioid overdose from 1999 to 2018

https://injuryfreenc.shinyapps.io/OpioidActionPlan/

Exemptions for E-Prescribe

The STOP Act notes multiple instances where the e-prescribe requirement will be exempt. The following exemptions are specified:

1. A clinician (other than a pharmacist) who dispenses to an ultimate user
2. Clinicians who prescribe controlled substances administered in a hospital, nursing home, hospice facility, outpatient dialysis facility, or residential care facility.
3. A clinician that experiences technological outages or failures. In this instance, clinicians must document the reason for exemption in the client’s medical record.
4. A clinician who prescribes medication dispensed by a pharmacy on federal property. In this instance, clinicians must document the reason for exemption in the client’s medical record.
5. Professional who practices veterinary medicine

These are the only exemptions for the e-prescribe requirement. If a practitioner does not currently e-prescribe, they must start in January 2020. The NC Medical Board does not find it acceptable for any practitioner to refer a patient to a hospital emergency room in January because they did not receive e-prescribe capabilities. Therefore, anyone who prescribes targeted controlled substances must begin the e-prescribing by the beginning of the new year.

How to E-prescribe Controlled Substances

Electronic Prescribing for Controlled Substances (EPCS) allows professionals to prescribe Schedule II-V controlled substances directly from point-of-care to pharmacy. E-prescribing is accurate, comprehensive, and secure. Under the Drug Enforcement Administration’s (DEA) regulations, EPCS has strict requirements. DEA’s strict rules work to verify prescribers and avoid errors to patients. Verification is conducted through identity proofing and 2nd-factor authentication. Although these rules make e-prescribing more complex, they work to decrease opioid misuse.

Often, electronic prescribing services are available within the prescriber’s EHR. When selecting an EHR, it is important to consider how its e-prescribing functionality meets the DEA’s complex regulations for EPCS. Consider asking about and researching your EHR’s electronic prescribing service. Patagonia Health integrates EPCS in our easy-to-learn solution. To learn more about how Patagonia Health can help you comply with the STOP Act, contact us today.