On July 1, new laws and rules go into effect for the prescribing and dispensing of controlled substances in Florida. Below is a snapshot of the changes and how they will affect you.
Limits Prescribing of Controlled Substances for Acute Pain
- Three-day limit prescription for acute pain
- Acute pain: the normal, predicted, physiological and time-limited response to an adverse chemical, thermal or mechanical stimulus associated with surgery, trauma or acute illness.
- Exceptions for acute pain includes cancer, a terminal condition, palliative care and traumatic injury.
- Exception to three-day limit is a seven-day limit prescription for acute pain (dentists can write a seven-day prescription using their professional judgement that their patient needs more than a three-day limit). Must write on prescription “acute pain exception” and document in patient’s record their acute medical condition and lack of alternative treatment.
- For treatment of pain other than acute pain, a prescriber must indicate “non-acute pain” on a prescription for an opioid drug listed as a Schedule II controlled substance.
Dispensing Limits on Practitioners
- Dispensing controlled substances listed in Schedule II, for the treatment of acute pain, may not exceed a three-day supply, or a seven-day supply based on the same parameters listed above for prescribers.
- Dispensing controlled substances listed in Schedule III, for the treatment of acute pain, may not exceed a 14-day supply.
- Verifying the identity of an individual must be done prior to dispensing a controlled substance, if not already known to the dentist.
Mandatory Two-hour CE Training on Controlled Substances
- All health care providers who are authorized to prescribe controlled substances and are registered with the United States Drug Enforcement Agency (DEA) to prescribe controlled substances must complete a board-approved two-hour continuing education (CE) course by Jan. 31, 2019, and at each subsequent licensure renewal. Failure to take the two-hour CE course could impact licensure renewal.
- The new law limits approved providers authorized to offer the two-hour CE course to include only statewide professional associations of physicians in Florida that are accredited to provide such educational courses (some collaborative efforts have been granted, but are limited, and must have approval from appropriate health care boards). The ONLY approved CE providers are: the Florida Medical Association, Florida Osteopathic Medical Association, Florida Academy of Family Physicians and Florida College of Emergency Physicians.
- This two-hour CE course is now available online. To access the course, please click here.
Mandates Checking the Prescription Drug Monitoring Program (PDMP) Database
- Florida’s PDMP database is known as E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program), which is administered through the Department of Health. To register, please click here. For step-by-step instructions on how to register, please click here.
- Providers must check the PDMP database (E-FORCSE) before prescribing or dispensing Schedules II, III, IV and V controlled substances for patients 16 years old or older starting on July 1, 2018. For a list of controlled substances, please click here. For step-by-step instructions on how to search for a patient in the PDMP, please click here. For step-by-step instructions on how to search for multiple patients at once, please click here.
- Providers are exempted from checking the PDMP database for “non-opioid” Schedule V controlled substances (does not contain any amount of a substance listed as an opioid).
- Health care providers are authorized to designate multiple staff members to check the PDMP on their behalf. For more information on designate/delegate management, please click here.
- Failure to check the PDMP database prior to the prescribing of a controlled substance could be subject to a non-disciplinary citation from the appropriate licensing board.