On April 2, 2018, the California Department of Justice (DOJ) certified that the Controlled Substance Utilization Review and Evaluation System (CURES) – California’s prescription drug monitoring database – was ready for statewide use.

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.

The California Medical Association (CMA) will continue to provide educational resources and work with the DOJ to ensure a smooth implementation of the new requirement. Physicians who experience problems with the new system should contact the DOJ CURES Help Desk at (916) 227-3843 or cures@doj.ca.gov. Providers are also encouraged to report these technical issues to CMA's Member Resource Center by calling (800) 786-4262.

(See also: Safe Prescribing)