CURES: mandatory check proposed

A check of the state's prescription drug monitoring program may become mandatory under a proposed bill requiring prescribers, including dentists with U.S. Drug Enforcement Administration registrations, to check the Controlled Substance Utilization Review and Evaluation System when writing a prescription for Schedule II-IV medications.    

SB 482 by Sen. Ricardo Lara (D-Bell Gardens) requires all providers to consult a patient's electronic history in the CURES database before prescribing a controlled substance to a patient for the first time, and at least once every four months thereafter when the prescribed controlled substance remains part of the patient's treatment.

CDA worked with the author to develop reasonable exemptions to the proposed mandatory check that allow dentists to rely on their professional judgment and utilize the CURES system, when necessary, to achieve the system's intended objectives. Those exemptions do not require a provider to check the database if the prescribed drug is part of a surgical procedure and in a non-refillable supply of five or fewer days. The exemptions uphold the intent of CURES to provide information that will help reduce opioid prescription abuse while removing an unnecessary burden when a patient needs pain medication. The proposed bill would not take effect until six months after DOJ certifies that CURES is ready for statewide use.

In recent years, government agencies and public health advocates have looked for tools to turn the tide on opioid abuse. California's CURES system upgrade and the requirement for prescribers to register, as well as last year's Schedule II reclassification of opioid combination drugs, are all part of these efforts. Prescribers in the U.S. write nearly 100 percent of opioid prescriptions worldwide, and in California alone, more than 1 billion dosage units of hydrocodone-combination products were dispensed in the 2013-14 fiscal year. Regardless of whether proposed legislation to require CURES use in California is successful, dentists are strongly encouraged to consult CURES when considering a controlled substance prescription for a new patient or a patient suspected of drug dependency.

To register for CURES, visit oag.ca.gov/cures. Dentists seeking help with CURES can access training videos, publications and an FAQ at: oag.ca.gov/cures/FAQs.

Additionally, DOJ offers the following information to clarify the enrollment process:

  • If already enrolled in CURES 1.0, a provider's registration carries over to CURES 2.0. Reregistration in CURES 2.0 is unnecessary if a provider was approved in the CURES 1.0 system.
  • CURES users' internet browsers must be compliant with the system's security requirements. This level of security is available on Microsoft Internet Explorer Version 11.0 or greater, Mozilla FireFox, Google Chrome or Safari. DOJ has not provided an exact date for how long CURES 1.0 will be available, and recommends users and prospective users update their web browsers to compliant web browsers as soon as possible.

CDA recently hosted a webinar to help guide members through the CURES registration process. To view the webinar, visit cda.org/cures. Additionally, the ADA is hosting a Sept. 2 webinar on safe opioid prescribing. Visit ada.org for additional information.

For more information on the current science and practice of pain management in dentistry, see the November 2015 Journal of the California Dental Association at cda.org/journal and attend the course, Pain Management and Opioid Reduction in Dentistry, at CDA Presents in San Francisco. Learn more about the types and frequency of opioid prescribing by dentists in the July 2016 issue of the Journal of the American Dental Association.

Patients with questions regarding the safety of opioids, can be referred to mouthhealthy.org/opioids.

Related Items

CDA recently hosted a webinar, presented by the Department of Justice, to assist member dentists with the Controlled Substance Utilization Review and Evaluation System (CURES 2.0) registration process and any questions they may have regarding the new system.

All prescribers in California with U.S. Drug Enforcement Administration (DEA) registrations are required to register by July 1 to access California's prescription drug monitoring program, known as CURES 2.0 (Controlled Substance Utilization Review and Evaluation System). Here are some common questions and answers for dentists related to the use of CURES.