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Florida requires physicians to discuss non-opioid alternatives with patients

Monday, July 1, 2019   (0 Comments)
Posted by: DCMS
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Effective today, July 1, 2019, all Florida physicians (with the exception of emergency services and care*) must discuss non-opioid alternatives to pain when prescribing opioids. This law was signed by Governor Ron DeSantis last week and goes into effect immediately. Below is a summary of how this will impact your practice. You can also click here for a pamphlet from the Florida Department of Health.

 

Physicians MUST:

1. Inform the patient of non-opioid alternatives for the treatment of pain, which may include non-opioid medicinal drugs, interventional procedures or treatments, acupuncture, chiropractic treatments, massage therapy, physical therapy, occupational therapy or any other appropriate therapy.

2. Discuss the advantages and disadvantages of the use of non-opioid alternatives, including whether the patients is at high risk of or has a history of, controlled substance abuse or misuse and the patient's personal preferences.

3. Provide the patient with an educational pamphlet regarding the use of non-opioid alternatives created by the Florida Department of Health.

4. Document the non-opioid alternatives considered in the patient's record. 

 

County Medical Society members from Coastal Spine and Pain have created the following MACROS for their EMR and have offered to share them to any physician who would like to use them to help streamline the process for requirement #4.

 

1. Acute pain  /  First opioid prescription MACRO:

The advantages and disadvantages of opioid therapy including but not limited to the risk of addiction, medication misuse, overdose, tolerance, respiratory depression and death were discussed with the patient. Alternatives such as NSAIDs, tylenol, therapy, ice, neuropathic medications, stretching and home exercise were discussed with the patient and the patient agreed to proceed and verbalized understanding. The Florida Department of Health opioid risk pamphlet was provided to the patient. 

 

2. Chronic pain / Continued opioid prescriptions MACRO:

The advantages and disadvantages of opioid therapy including but not limited to the risk of addiction, medication misuse, overdose, tolerance, respiratory depression and death were discussed with the patient now and/or in the past. Alternatives such as NSAIDs, tylenol, therapy, ice, neuropathic medications, stretching and home exercise were discussed with the patient and the patient agreed to proceed and verbalized understanding.The Florida Department of Health opioid risk pamphlet was/has been previously provided to the patient. 

 

3. Acute pain / Post surgical pain MACRO

The advantages and disadvantages of opioid therapy including but not limited to the risk of addiction, medication misuse, overdose, tolerance, respiratory depression and death were discussed with the patient now and/or in the past. Alternatives such as NSAIDs, tylenol, ice, heat, neuropathic medications, stretching, biofeedback, meditation and home exercise were discussed with the patient and the patient agreed to proceed and verbalized understanding.The Florida Department of Health opioid risk pamphlet was previously provided to the patient.  

 

*   “Emergency services and care” means medical screening, examination, and evaluation by a physician, or, to the extent permitted by applicable law, by other appropriate personnel under the supervision of a physician, to determine if an emergency medical condition exists and, if it does, the care, treatment, or surgery by a physician necessary to relieve or eliminate the emergency medical condition, within the service capability of the facility.