Thousands of N.C. Doctors Over-Prescribing Opioids Despite New Law

The News & Observer reports that thousands of North Carolina doctors appear to be breaking a new state law that limits opioid prescriptions for patients using the addictive drugs for the first time, according to preliminary data from the N.C. Department of Health and Human Services and the state's largest health insurer, Blue Cross and Blue Shield.

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The report notes:


“The NC STOP Act, enacted June 29 and effective Jan. 1, limits opioid prescriptions to five days for first-time patients with short-term pain, or seven days if the patient had surgery. The law, which is intended to stop patients from getting more opioids than they need, is a response to a grave public health concern that leftover narcotics could be taken recreationally or sold, feeding an opioid epidemic that claimed 12,590 lives in North Carolina between 1999 and 2016.

The data from the state health department shows that in March more than 16,000 physicians across the state prescribed opioids for over a week to at least one patient who had not had a prescription in six months. But the agency noted that additional information was needed to determine if those prescriptions actually violated the law.

The agency presented its preliminary report Tuesday to the staff of the N.C. Medical Board, the state body that licenses and disciplines the 27,000 doctors working in the state. It was the first time DHHS had provided the Board with such a list. The data comes from the state's controlled substances reporting system, a database of prescriptions doctors and pharmacists can use to see if a patient is getting opioids from multiple doctors. The challenge for DHHS and the Medical Board is that the database does not contain the medical details necessary to filter out irrelevant cases and determine if the prescription violates the STOP Act.”

Doctors are writing legitimate prescriptions for pills that can be filled for 30 days, when just five or seven days are needed. The story continues:

"‘Doctors are writing [prescriptions], pharmacies are filling them,’ said Estay Greene, Blue Cross's vice president of pharmacy programs. ‘If a prescription is written and you only end up using it for three days, and the doctor wrote it for 30 days, you have 27 days of opioids sitting in your medicine cabinet.’

In April, Blue Cross started electronically blocking prescriptions from being filled beyond seven days. The insurer says the policy blocked more than 1,100 prescriptions and prevented between 25,000 and 30,000 opioid pills from being dispensed to patients in the first two weeks of its implementation. Based on that figure, the company estimates that 225,000 to 275,000 opioid painkillers have been over-prescribed on its commercial plans between Jan. 1 and mid-April.

Under the NC STOP Act, after the initial five- and seven-day limit, the patient can receive another prescription if the pain continues and requires medication.”

Read the rest of this story on The News & Observer.

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