Frequently Asked Questions

“Acute pain” is the normal, predicted, physiological, and time-limited response to an adverse chemical, thermal, or mechanical stimulus associated with surgery, trauma, or acute illness. It does not include pain related to cancer, terminal conditions, pain treated with palliative care, or traumatic injuries with an Injury Severity Score of 9 or greater.

Exceptions to acute pain limits:

1. cancer,
2. a terminal condition (a progressive disease or medical or surgical condition that causes significant functional impairment, is not considered by the treating physician to be reversible without the administration of life-sustaining procedures, and will result in death within 1 year after diagnosis if the condition runs its normal course),
3. pain treated with palliative care (the provision of relief for symptoms related to an incurable, progressive illness or injury), and
4. a traumatic injury with an Injury Severity Score of 9 or higher. See Trauma.org for more information.

**The law did not change prescribing of controlled substances for treatment of nonacute pain or chronic nonmalignant pain.

Yes. If the prescription is for a greater than a 7-day supply, the prescriber must indicate “Non-Acute Pain.”

No. The law provides that for the treatment of acute pain, a prescription for an opioid drug listed as a Schedule II controlled substance in s. 893.03 or 21 U.S.C. s. 812 may not exceed a 3-day supply, except that up to a 7-day supply may be prescribed if certain conditions are met. The “3-day” and “7-day” applies to the supply of the opioid drug listed as a Schedule II controlled substance, not the number of days after the prescription is written for which it is still valid.

No. The law only requires the words “ACUTE PAIN EXCEPTION” to be written for prescriptions greater than a 3-day and up to a 7-day supply. Please see Section 456.44(5)(a)(2), F.S.

A prescribing practitioner may prescribe up to a 7-day supply if the prescriber:

1. determines it is medically necessary;
2. indicates “acute pain exception” on the prescription; AND
3. documents the acute medical condition and lack of alternative treatment options that justify deviation from the 3-day supply limit in the patient’s medical record.

No. The law does not require the words “Acute Pain” to be written on a prescription, but rather the words “ACUTE PAIN EXCEPTION” for prescriptions greater than a 3-day and up to a 7-day supply. Please see Section 456.44(5)(a)(2), F.S

Yes. If a prescription for a Schedule II opioid does not meet the requirements as specified in Section 456.44, F.S., the pharmacist should follow their current standard policy and procedures by contacting the prescribing practitioner to verify written information contained within the prescription. Any deviation or change in the prescription should be promptly reduced to writing and properly annotated based on your current pharmacy practice.

No. The new law does not require monthly visits if a patient’s condition is treated with a controlled substance. Your treating physician may choose to follow guidelines or recommendations from other sources, such as the CDC or DEA, but the controlled substance law does not include a requirement for monthly visits.

No. The new law does not require urine testing. Your treating physician may choose to follow guidelines or recommendations from other sources, such as the CDC or DEA, but the controlled substance law does not include a requirement for regular urine tests.

No. The “Controlled Substance Prescriber” designation found on the Department of Health’s website, is only an indicator by the prescribing practitioner that he/she prescribes controlled substances for the treatment of chronic non-malignant pain. It is for patient information only and does not affect the authority of a physician to write prescriptions for Schedule II opioids.

Physician, Dentist, Podiatrist, Certified Optometrist, Advanced Practice Registered Nurse, and Physician Assistant.