Frequently Asked Questions

Yes. If the “note” is transmitted with or considered to be part of the actual electronic prescription to be transmitted to the pharmacist, then the annotation of “Acute Pain Exception” or “Non-Acute Pain” would be acceptable.

No. The days supply limits apply to Schedule II opioids prescribed for the treatment of acute pain.

No. For example, the day supply limits do not apply to Hycodan® Cough Syrup for a patient who is being treated for an unrelenting cough or to Ritalin® for a patient being treated for ADHD. The 3-day and up to 7-day limits apply to Schedule II opioids prescribed for the treatment of acute pain.

When prescribing opioids to a patient with an Injury Severity Score of 9 or higher, the prescriber must:

1. Prescribe an emergency opioid antagonist AND
2. Indicate “nonacute pain” on the prescription

“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 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 justification for deviating from the 3-day supply limit in the patient’s medical record.

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.