STOP Writing Paper Buprenorphine Prescriptions in North Carolina






The North Carolina STOP Act of June 2017 says that all Schedule 2 or 3 opioid medications must be prescribed electronically as of January 1, 2020. I blogged about this before, on September 8th of 2019, but I wasn’t sure buprenorphine was included.

Now I’m sure that it is included. I communicated with the NC Attorney General’s office and was assured all buprenorphine products are on the list of opioids which must be electronically prescribed.

Most providers probably already have e-prescribing. But in the OBOT (office-based opioid treatment) world, there are many small practices who may not yet have switched to E-prescribing. It is imperative that you do so by January 1, 2020.

According to the medical board’s website, it doesn’t matter if you only plan to write a few opioid prescriptions per year. The quantity prescribed doesn’t exempt you for the e-prescribing mandate.

I’m a little worried about the opioid treatment programs that also have some office-based patients for whom they prescribe. Most OTPs have electronic medical records, but these aren’t set up to communicate with local pharmacies. I don’t know what kind of solution will be found for these patients and their physicians, but I imagine each facility will need to purchase e-prescribing capabilities…and they will need to do it quickly, given the deadline looming one month away. Hopefully these programs already have provisions to comply with the new law.

What will happen if you ignore the new law and continue to issue paper prescriptions? Per the NC medical board website, it’s initially up to the pharmacy. They can choose to fill a paper prescription, or they may call the prescriber to make sure he/she knows about the new law. With repeated paper prescriptions, pharmacies can report these prescribers to the medical board for investigation. The medical board’s website says it will “…determine an appropriate resolution based on the individual circumstances of each case.”

Like all prescribers, I prefer not to come to the attention of our medical board as a provider who is violating the law. I don’t plan to put myself in the position to find out what “appropriate resolution” means. I encourage other buprenorphine prescribers to comply with the STOP Act, so they won’t have to worry about it either.

E-prescribing is relatively easy to learn. If I was able to use it after a few hours of instruction, anyone can learn it, because I’m naturally slow to grasp technical or electronic learning challenges. The program I purchased for my office doesn’t cost much, only about $30 to $50 per month for a program that meets DEA security standards.

Here’s a link to the DEA’s website with answers to questions about E-prescribing systems in general:

Here’s a link to the NC medical board’s FAQ page about E-prescribing compliance with the STOP Act:

I’m happy with my E-prescribing system. It still takes me a minute or two longer to complete than paper prescriptions, but there’s better security, which makes me feel better.

3 responses to this post.

  1. With Netalytics/Methasoft it would be easy to have them turn on the e-prescribing feature via Dr First… But I’m not sure about other EHRs in the OTP world. Netalytics is one of the few that’s positioned well for both OTPs and OBOTs.


  2. Posted by candoitbetter23 on December 19, 2019 at 12:15 am

    This only hurts bupe patients and staff
    The biggest schedule 3 prescribed with the most regularity is buprenorphine
    Pharmacies lose alot to multiple coupons but you have to switch pharmacies every month causing undeserved points in the monitoring system for switching for a better deal that saves $50-200

    They know eventually most clinics wont change every month, will send to original pharmacy or lose or wont send completely

    Providers and patients suffer at first
    Like always just patients in the end more work, more uncertainty, more money



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