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.

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

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.

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.

After consulting with a physician licensed under chapter 458 or chapter 459 who is skilled in diseases of the eye, 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 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.