Navigating North Carolina’s New STOP Act: How Can We Help?


The C.A.R.E. Coalition is working toward a healthy, vibrant Transylvania County, free of substance abuse and underage drinking. In light of North Carolina’s new STOP Act that affects prescribing practices for opioids, we want to offer support and resources to local physicians.



The Strengthen Opioid Misuse Prevention Act of 2017, or STOP Act, is intended to reduce the supply of unused, misused and diverted opioids circulating in North Carolina, reduce “doctor shopping,” and improve care by requiring prescribers to use tools and resources that help prevent inappropriate prescribing. North Carolina is one of 17 states that has passed similar laws, and the act was supported by the North Carolina Medical Board.

Key provisions of the STOP Act include:

  • Limits on the number of days’ worth of opioids that may be lawfully prescribed upon initial consultation for acute injuries (no more than a five-day supply) and following surgeries (no more than a seven-day supply). The STOP Act does NOT limit the amount of opioids that may be prescribed to a chronic pain patient;
  • A requirement that prescribers use the NC Controlled Substances Reporting System (NCCSRS), the prescription database that records all controlled substance prescriptions dispensed in outpatient pharmacies across North Carolina. The STOP Act requires prescribers to review the patient’s 12-month history with the NCCSRS before issuing an initial prescription for a Schedule II or Schedule III opioid, and conduct subsequent reviews every 3 months thereafter, for as long as the patient continues on the drug;
  • A requirement that PAs and NPs practicing at pain clinics consult prednisone with their supervising physicians prior to prescribing opioids. NOTE: The North Carolina Medical Board prednisone has not determined how it will define “consult”. The most important thing is that a meaningful consultation about the patient and recommended treatment occurs and is documented in the medical record; the Board may ultimately leave it up to PAs, NPs, and their supervisors to determine exactly how consultations occur, consistent with its current approach towards physician supervision of PAs and NPs.



For more information, including a summary of the STOP Act and a list of FAQs, visit the North Carolina Medical Board website at

For resources from the CDC intended for healthcare providers, including best practices and guidelines for prescribing opioids for chronic pain, visit

To learn more about the U.S. Surgeon General’s “Turn the Tide” initiative for providers to pledge to work toward ending the opioid crisis, visit

For continuing education on topics including treatment of chronic pain and opioid use disorder, visit the Mountain Area Health Education Center (MAHEC) website at