Mutual Matters

Opioids – The North Carolina STOP ACT

Posted by Blake Fagan, MD on Sep 14, 2017 12:30:00 PM

IMMIC_Blue_Pills_Meds-3.jpgn the fight against the opioid epidemic, The North Carolina STOP Act (Strengthen Opioid Misuse Prevention) is a start.

As you may have heard, the STOP Act bill was signed into law on June 29, 2017. Here are some facts about how it will affect providers.

The following prescribing limits go into effect January 1, 2018:

  • If you are going to prescribe opioids for acute pain, you will be limited to a five-day supply or less with the initial prescription.
  • If you are going to prescribe opioids for post-operative pain, you are limited to a seven-day supply or less with the initial prescription.
  • Further opioid refills require a subsequent consultation. The provider may issue an appropriate refill with the consultation.
  • Providers should review a patient’s 12-month history in the NC Controlled Substance Reporting System (CSRS) prior to providing any opioid for pain and, if providing opioids on an ongoing basis, like for chronic pain, should review the patient’s history in the CSRS every three months thereafter. The review must be documented in the chart, or when applicable, document the technical reason that kept the provider from reviewing the CSRS.

The above rules are not required for hospice, palliative care, patients with cancer, patients in the hospital or in long-term care facilities.

So, now you know the summary of the law and how it affects us, but why did the government pass this law? Four people die every day in North Carolina from an opioid overdose. In 2015, patients in NC were dispensed 660 million opioid pills. We, as a medical community, were asked to prescribe less opioid pills. In 2016, patients in NC were dispensed 700 million opioid pills.  Furthermore, data shows that if an opioid naïve adult is prescribed a 30-day supply of an opioid prescription, he/she has a 35% chance of being on an opioid at one year and a 20% chance of being on an opioid at three years. The data shows that the increased risk of staying on an opioid starts to rise after five days of taking an opioid prescription.

To read the North Carolina Medical Board’s summary of the STOP Act, click here. To read the full text of the STOP Act, click here.

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