NC STOP ACT: Mandatory Use of Controlled Substances Reporting System (CSRS) effective July 7, 2021

The “mandatory use” provision of the NC STOP Act becomes effective July 7, 2021. Under this provision, prescribers and dispensers of a controlled substance MUST perform a search of a patient's prescription history in PMP AWARE (North Carolina’s Controlled Substances Reporting System) before a controlled substance can be prescribed or dispensed. This system is intended to be used as a clinical tool to improve patient care and safety while avoiding potential drug interactions and identifying individuals that may be in need of referral to substance use disorder services. In addition, prescribers can audit their personal controlled substances prescribing history.

What is the NC Controlled Substances Reporting System (CSRS)?

The NC Controlled Substances Reporting System (NC CSRS) is the statewide database that includes prescribing information about every controlled substance dispensed in an outpatient setting. NC CSRS is run by the NC Drug Control Unit, which is part of the Mental Health, Developmental Disabilities and Substance Use Division of the NC Dept. of Health and Human Services (NC DHHS). Learn more about the NC CSRS on the NCDHHS CSRS Webpage.

Who can access the NC CSRS?

Prescribers must personally register for access to NC CSRS. Prescribers should also consider registering one or more delegates to manage the increased workload associated with obtaining patient prescription histories. A delegate is authorized to obtain patient prescription histories on behalf of a designated prescriber or prescribers. Any individual who does not have prescriptive authority, such as an RN or administrative staff person, may register as a delegate.

For more information about how to register for access, review the PMP AWARE Account Registration Tutorial

Click on the link to register for access to the PMP AWARE system.

Once registered users have been approved, they may access the NC CSRS via the PMP AWARE site.

Refer to the PMP AWARE User Guide for more information about how to search for and review a patient’s prescription history.

What are providers required to do under the “mandatory use” provision of the NC STOP ACT?

• REVIEW: Prior to initially prescribing a targeted controlled substance to a patient, a practitioner shall review the information in the controlled substances reporting system pertaining to the patient for the 12-month period preceding the initial prescription. For every subsequent three-month period that the targeted controlled substance remains a part of the patient's medical care, the practitioner shall review the information in the controlled substances reporting system pertaining to the patient for the 12-month period preceding the determination that the targeted controlled substance should remain a part of the patient's medical care.
  
  
• DOCUMENT: Each instance in which the practitioner reviews the information in the controlled substances reporting system pertaining to the patient shall be documented in the patient's medical record. In the event the practitioner is unable to review the information in the controlled substances reporting system pertaining to the patient because the system is not operational or there is some other temporary electrical or technological failure, this inability shall be documented in the patient's medical record. Once the electrical or technological failure has been resolved, the practitioner shall review the information in the controlled substances reporting system pertaining to the patient and the review shall be documented in the patient's medical record.

Optional Use:

A practitioner may, but is not required to, review the information in the controlled substances reporting system pertaining to a patient prior to prescribing a targeted controlled substance to the patient in any of the following circumstances:

• The controlled substance is to be administered to a patient in a health care setting, hospital, nursing home, outpatient dialysis facility, or residential care facility, as defined in G.S. 14-32.2.
• The controlled substance is prescribed for the treatment of cancer or another condition associated with cancer.
• The controlled substance is prescribed to a patient in hospice care or palliative care.

Auditing of Provider Use

The Department shall conduct periodic audits of the review of the controlled substances reporting system by prescribers. The Department shall determine a system for selecting a subset of prescriptions to examine during each auditing period. The Department shall report to the appropriate licensing board any prescriber found to be in violation of this section. A violation of this section may constitute cause for the licensing board to suspend or revoke a prescriber's license.