Controlled Substances (Support)

Controlled Substances (Support)

CS/CS/HB 21 (Boyd) and CS/SB 8 (Benacquisto) are comprehensive proposals to address the opioid crisis in Florida. CS/SB 8 proposes a three-day limit on the supply of opioids prescribed for acute pain, unless strict conditions are met for a seven-day supply. All health care professionals that prescribe or dispense medication would be required to participate in the Florida Prescription Drug Monitoring Program under the bill. CS/SB 8 also requires pharmacists to check the purchaser’s identification prior to dispensing a controlled substance. CS/SB 8 was amended to require each person registered to prescribe controlled substances to complete a board-approved two-hour continuing education course on prescribing controlled substances as part of biennial license renewal. 

CS/CS/HB 21 was significantly amended in the House Appropriations Committee on February 21 and addresses opioid abuse by expanding the use of the Prescription Drug Monitoring Program (PDMP), increasing regulation of prescribers and dispensers, and aligning state criminal statutes with federal law. 

CS/CS/HB 21 limits the prescription for a Schedule II opioid to alleviate acute pain to a three-day supply, or a seven-day supply if deemed medically necessary by the prescriber. The bill excludes pain related to cancer, terminal illness, palliative care and serious traumatic injury from these prescribing limits. The bill requires the Department of Health (DOH) to adopt rules establishing guidelines for prescribing controlled substances for acute pain. The bill also requires an authorized health care practitioner to review a patient’s PDMP history prior to prescribing or dispensing a controlled substance, with exemptions. The bill authorizes a prescribing practitioner who is approved to provide medically assisted treatment for opioid addiction to dispense Schedule III substances for such purpose. 

Currently, a pain management clinic must register with DOH, unless it self-determines it is exempt from registration. The bill requires all clinics that claim an exemption from registration to obtain a certificate of exemption by January 1, 2019. 

The bill expands the PDMP reporting requirements to include certain Schedule V substances and additional information not currently collected, such as the patient’s telephone number, certain information on the person picking up the controlled substance on behalf of the patient, and whether the prescription is new or a refill. The bill authorizes health care employees of the U.S. Department of Defense and the Indian Health Service who prescribe or dispense controlled substances to have direct access to the PDMP, and authorizes indirect access to the PDMP for district medical examiners under certain conditions. The bill authorizes DOH to share and exchange PDMP data with other states if certain conditions are met, and authorizes the PDMP to interface with a health care practitioner and facility electronic health record systems. 

CS/CS/HB 21 aligns the state schedule of drugs with the federal schedule of drugs and makes it a crime to possess, purchase, deliver or sell a tableting machine, encapsulating machine or controlled substance counterfeiting material for the purpose of illegally manufacturing controlled substances. The bill increases the level of offense for health care practitioners who prescribe controlled substances that are unnecessary from a third-degree felony to a second-degree felony. (Cook)