The CURES (Controlled Substance Utilization Review and Evaluation System) hasbeen certified as of April 2nd to be ready for statewide use. Thisdatabase allows physicians to be able to check for controlled substanceprescriptions on any of their patients, which can be a great tool in combatingopioid misuse and addiction. There is already a 2016 California law inplace requiring that physicians check this database; it was awaiting thiscertification to activate and will be effective as of October 2, 2018. According to the law, a physician must check the database prior toprescribing a controlled substance to the patient for the first time, and atleast once every four months thereafter. There are some exceptions whichallow short term prescriptions from the emergency department or as part of asurgical procedure, or for patients on hospice care; and exceptions whentechnological limitations that are beyond the control of the physician make itimpossible. There are efforts to try to link the California state database with databasesfrom other states – currently about 39 states have some sort of controlledsubstance database although the details vary from state to state, and of coursepatients do not necessarily get all of their medications in just one state. CMA would also like to see the database moved to be part of the department ofpublic health as it is in many of these other states, so that the emphasis wouldbe focused on health rather than law enforcement. Getting thedatabase to interact with our electronic medical record systems would alsoincrease its effectiveness and decrease the administrative burden forphysicians. Finally, there is a bill in the legislature (AB 2086) whichwould allow a provider to get a list of CURES data for all of the patients forwhich they prescribe, rather than having to query the database one patient at atime. Another bill (AB1752) suggests that schedule V drugs (which aremedications like cough syrups with codeine) should be added to the database. One of the concerns about the database is monitoring it for appropriatepatient privacy, or who should determine when the database should be mined. I have been told that the Medical Board of California is going through therecords of all people who died from drug overdose in 2012 and 2013 and will beusing the CURES database to investigate the physicians involved in prescribingfor these people. This investigation may find some cases of inappropriateprescribing, but at what disruption to many other doctor’s practices – doctorswho were and are trying to appropriately provide care for their patients who arein pain. And there are several cases where the California Medical Boardhas pushed to look at medical prescribing for a patient who has not given orwithdrawn consent of their medications to be looked at, as well as a case whereOregon is refusing to give their database information to the federal government. Hopefully the CURES database will continue to improve care for patients andthe upcoming mandate will be manageable by physicians. I am happy to be apart of the Board of Trustees and know that the California Medical Associationis involved in many aspects of this evolving situation. Please feelfree to contact me at any time with your ideas or input on this issue or anyothers in organized medicine. Dr. Weissman is a member of the SMCMA Board of Directors and represents theSpecialty Section on the CMA Board of Trustees.