CURES (California state prescription history database) has been around since 1997 but not many providers took advantage of what it has to offer. Ignoring CURES is ignoring a tool that could shine light on what is really happening with the patient. News are full of stories describing opioid deaths, which could have been easily prevented if prescribers performed database checks. See L.A. Time coverage of an opioid death of a 59-year-old patient who received 75 prescription by three primary care doctors, a psychiatrist and a pain specialist in one year. None of her providers knew what the others were prescribing – none of them utilized CURES.
The legislature decided to take matters in its hands and starting October 2, California prescribers must consult CURES prior to prescribing controlled substance to new patients or once every four months if a prescription remains a part of the patient’s treatment plan.
Emergency departments and surgical teams can prescribe a nonrefillable five-day supply without first consulting CURES. In other emergency situations – when checking CURES is not reasonably possible – a five-day nonrefillable supply is also allowed, but the prescriber must document the reason for skipping consultation.
Hospice care patients are exempted. In addition, Schedules V are not reportable to CURES, so no verification is needed if provider prescribes a Schedule V drug.
What does it mean for pharmacies?
Pharmacists are not among the providers who must verify CURES. Corresponding responsibility laws and requirements that pharmacists consult available records prior to dispensing, make it imperative for pharmacists to run CURES reports on all new patients receiving Schedule II-IV medications and existing patients every 4 months. As I mentioned in a related blog post, there were too many disciplinary cases against pharmacies and pharmacists – on the state and federal levels – where pharmacies performed their due diligence but failed to verify CURES prior to dispensing. As a result, they were faced with DEA registration revocations, monetary penalties, and the Board of Pharmacy actions. All could have been avoided if pharmacists consulted CURES prior to dispensing.
If you are a pharmacy owner or a pharmacist-in-charge, make sure that your policies and procedures on dispensing controlled substances are updated and you follow the recommended procedure on verifying CURES prior to dispensing to any new patients and periodically to the existing patients. It can save your license and your business.