Is an in-person visit required for opioid prescription in Florida?

From the Guidelines

An in-person visit is generally required for opioid prescriptions in Florida, as the state law mandates a legitimate physician-patient relationship, typically established through an in-person physical examination, before prescribing controlled substances like opioids. The Florida Board of Medicine regulations emphasize the importance of a prior in-person evaluation to ensure a legitimate physician-patient relationship, making it clear that prescribing opioids solely based on an online questionnaire or telemedicine consultation without a prior in-person evaluation is considered inappropriate and potentially illegal 1. Some exceptions may apply, such as for hospital inpatients, hospice patients, or in certain emergency situations. Furthermore, Florida's Prescription Drug Monitoring Program (PDMP) requires prescribers to consult the database before prescribing opioids, aiming to reduce prescription drug abuse and ensure medical necessity for opioid medications. Key aspects of Florida's regulations include:

• Establishing a legitimate physician-patient relationship through an in-person physical examination
• Limited exceptions for specific patient groups, such as hospital inpatients or hospice patients
• Mandatory consultation of the PDMP database before prescribing opioids
• Restrictions on prescribing opioids solely based on online questionnaires or telemedicine consultations without prior in-person evaluations. Patients seeking opioid prescriptions should plan to visit their healthcare provider in person, bringing relevant medical records to document their condition and treatment history.

From the Research

Opioid Prescription Requirements in Florida

• The provided studies do not explicitly state that an in-person visit is required for opioid prescription in Florida per law 2, 3, 4, 5.
• However, the studies discuss the implementation of various laws and programs in Florida aimed at reducing opioid prescribing and use, such as the Prescription Drug Monitoring Program and pill mill laws 3, 4.
• One study mentions the COVID-19 pandemic leading to the transition of a medical student-run clinic to a telemedicine model for medications for opioid use disorder in Miami, Florida, suggesting that telemedicine may be used for opioid prescription in certain circumstances 2.
• Another study assesses the changes in opioid use after Florida's restriction law for acute pain prescriptions, but does not provide information on in-person visit requirements 5.
• Overall, the studies do not provide a clear answer to the question of whether an in-person visit is required for opioid prescription in Florida per law.

Telemedicine and Opioid Prescription

• The studies suggest that telemedicine may be used for opioid prescription and management in certain circumstances, such as during the COVID-19 pandemic 2, 6.
• However, the studies also highlight the challenges and limitations of telemedicine for opioid prescription and management, such as loss of contact, greater miscommunication, and less comprehensive care interactions 6.
• The use of telemedicine for opioid prescription and management may be influenced by various factors, including patient burden, communication and technology challenges, pain control, opioid misuse, and medical complexity 6.