The California Department of Justice (DOJ) has certified that as of April 2, 2018, the Controlled Substance Utilization Review and Evaluation System (CURES) – California’s prescription drug monitoring database – is ready for statewide use. The certification starts a six-month implementation period for the duty to consult requirements enacted by the Legislature in SB 482 (Lara, 2016).
Effective October 2, 2018, physicians must consult CURES prior to prescribing Schedule II, III or IV controlled substances to a patient for the first time and at least once every four months thereafter if that substance remains part of the patient’s treatment. Physicians must consult CURES no earlier than 24 hours or the previous business day prior to the prescribing, ordering, administering or furnishing of a controlled substance to the patient.
This law provides, however, that the requirement to consult CURES would not apply if doing so would result in the patient’s inability to obtain a prescription in a timely manner and adversely impact the patient’s conditions so long as the quantity of the controlled substance does not exceed a five-day supply.
Physicians are also not held to this duty to consult when prescribing controlled substances to patients who are:
- Admitted to a facility for use while on the premises;
- In the emergency department of a general acute care hospital, so long as the quantity of the controlled substance does not exceed a seven-day supply;
- As part of a surgical procedure in a clinic, outpatient setting, health facility or dental office, so long as the quantity of the controlled substance does not exceed a five-day supply; or
- Receiving hospice care.
In addition, there are exceptions to the duty to consult when access to CURES is not reasonably possible, CURES is not operational or the database cannot be accessed because of technological limitations that are beyond the control of the physician.
As of July 1, 2016, the law mandates that all California licensed physicians authorized to prescribe scheduled drugs and registered with the Drug Enforcement Administration be registered to access CURES.
For more information on CURES and the upcoming duty to consult, see CMA On-Call document #3212, “California’s Prescription Drug Monitoring Program: The Controlled Substance Utilization Review and Evaluation System (CURES)” or visit the DOJ’s website and CURES user guide.
CMA will continue to provide educational resources and work with the DOJ to ensure a smooth implementation of the new requirement.
It’s a good idea to check these databases when prescribing controlled substances. I think most good clinicians do so.