Effective July 1, 2018, Schedule II opioids prescribed for the treatment of acute pain must not exceed a three-day supply. Acute pain is defined as:
[The] normal, predicted, physiological, and time-limited response to an adverse chemical, thermal, or mechanical stimulus associated with surgery, trauma, or acute illness. The term does not include pain related to:
- A terminal condition …“terminal condition” means a progressive disease or medical or surgical condition that causes significant functional impairment, is not considered by a 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.
- Palliative care to provide relief of symptoms related to an incurable, progressive illness or injury.
- A traumatic injury with an Injury Severity Score of 9 or greater.
456.44(1)(a), Fla. Stat. (2018)
[However,] a 7-day supply may be prescribed if:
- The prescriber, in his or her professional judgment, believes that more than a 3-day supply of such an opioid is medically necessary to treat the patient’s pain as an acute medical condition;
- The prescriber indicates “ACUTE PAIN EXCEPTION” on the prescription; and
- The prescriber adequately documents in the patient’s medical records the acute medical condition and lack of alternative treatment options that justify deviation from the 3-day supply limit established in this subsection.
456.44(5)(a), Fla. Stat. (2018)
When prescribing Schedule II opioids for non-acute pain (e.g. chronic nonmalignant pain), prescribers must indicate on the prescription “NONACUTE PAIN.” Chronic nonmalignant pain is not subject to the 3-day/7-day prescribing limitation.