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CURES Mandatory Use
The Controlled Substance Utilization Review and Evaluation System (CURES) was certified for statewide use by the Department of Justice (DOJ) on April 2, 2018. Therefore, the mandate to consult CURES prior to prescribing, ordering, administering, or furnishing a Schedule II-IV controlled substance became effective October 2, 2018. The law has since been amended to include Schedule V controlled substances. Here is everything you need to know.
Note: The phrase "controlled substance" as used in this guide refers to a Schedule II, Schedule III, or Schedule IV, or Schedule V controlled substance.
When must I consult CURES?
- The first time a patient is prescribed, ordered, administered, or furnished a controlled substance, unless one of the exemptions below apply.
- Within the twenty-four-hour period, or the previous business day, before prescribing, ordering, administering, or furnishing a controlled substance, unless one of the exemptions below apply.
- Before subsequently prescribing a controlled substance, if previously exempt.
- At least once every six months if the controlled substance remains a part of the patient's treatment plan.
"First time" is defined as the initial occurrence in which a health care practitioner intends to prescribe, order, administer, or furnish a controlled substance to a patient and has not previously prescribed a controlled substance to the patient.
Who is required to consult CURES?
Any health care practitioner authorized to prescribe, order, administer, or furnish a controlled substance, including:
- Physician and Surgeon
- Certified Nurse Midwife (Furnishing)
- Dentist
- Naturopathic Doctor
- Nurse Practitioner (Furnishing)
- Optometrist
- Physician Assistant
- Podiatrist
Note: This requirement does not apply to veterinarians or pharmacists.
What are the consequences for failing to consult CURES?
A health care practitioner who fails to consult the CURES database must be referred to their state professional licensing board for administrative sanctions, as deemed appropriate by that board.
What exemptions are there to consulting CURES?
A health care practitioner is exempt from consulting the CURES database before prescribing, ordering, administering, or furnishing a controlled substance in any of the following circumstances:
- While the patient is admitted to, or during an emergency transfer between a
- In the emergency department of a general acute care hospital, and the controlled substance does not exceed a non-refillable seven-day supply.
- When buprenorphine, or another controlled substance containing buprenorphine, is prescribed, ordered, administered, or furnished in the emergency department of a general acute care hospital.
- As part of a patient's treatment for a surgical procedure, and the controlled substance does not exceed a non-refillable five-day supply when a surgical procedure is performed at a
- The patient is receiving hospice care.
The facilities listed are specifically defined in statute. Click on the facility type for more details on the facility requirements.
"Place of Practice" is defined as a Dental Office pursuant to Business and Professions Code (BPC) §1658.
Further Exemptions
What if it is not reasonably possible for a prescriber to access the information in CURES in a timely manner?
- If another individual with access to CURES is not reasonably available, a five-day supply of the controlled substance can be prescribed, ordered, administered, or furnished as long as there is no refill allowed. In addition, the prescriber must document in the patient's medical records the reason for not consulting CURES.
What if I determine that consulting CURES would result in a patient's inability to obtain a prescription in a timely manner and thereby adversely impact the patient's medical condition?
- A prescriber may provide a non-refillable five-day supply if they make this determination. The prescriber must document in the patient's medical records the reason for not consulting CURES.
What if I experience technical difficulties with CURES?
- There are exemptions to consulting CURES if there are technical difficulties accessing CURES, such as CURES is temporarily unavailable for system maintenance, or you experience temporary technological or electrical failure and CURES cannot be accessed (e.g., power outage due to inclement weather).
- A prescriber should contact the CURES Help Desk at (916) 210-3187 or CURES@doj.ca.gov for assistance accessing their CURES account.
Note: A prescriber must, without undue delay, seek to correct any cause of the temporary technological or electrical failure that is reasonably within their control.
What protections are there for prescribers?
- There is no private cause of action for a prescriber's failure to consult CURES.
- For complete information on the mandatory requirement to consult CURES, please read HSC §11165.4.
If you have any further questions, please seek legal counsel.