From the Guidelines
Nurse practitioners in Florida can prescribe chronic pain medications, including controlled substances, under certain conditions and limitations, as outlined in the state's regulations and guidelines, such as those found in 1 and 1.
Key Considerations
- Nurse practitioners (NPs) in Florida must operate under a supervisory protocol with a physician to prescribe controlled substances for chronic pain management.
- The protocol must be in writing and filed with the Florida Board of Nursing.
- For Schedule II medications, NPs are generally limited to prescribing a 7-day supply, though extensions are possible with proper documentation for certain conditions.
- NPs must complete specific continuing education requirements on controlled substance prescribing and register with the DEA to obtain a prescriber number.
- Consultation of the state's Prescription Drug Monitoring Program (PDMP) is required before prescribing controlled substances to review the patient's medication history.
Rationale
The regulations and guidelines, as discussed in 1 and 1, emphasize the importance of careful oversight and monitoring of prescribing practices for controlled substances used in chronic pain management due to their significant risks for dependence, addiction, and diversion.
Best Practices
- NPs should prioritize nonpharmacologic and nonopioid pharmacologic therapies whenever possible, as recommended in 1 and 1.
- When opioids are necessary, the lowest effective dose should be prescribed for the shortest duration, with regular reassessment of benefits and risks.
- Patient education on the risks and benefits of opioid therapy, as well as the importance of safe storage and disposal of medications, is crucial.
- Regular consultation of the PDMP and adherence to the guidelines outlined in 1 and 1 can help minimize risks associated with opioid prescribing.
From the Research
Nurse Practitioners' Prescribing Authority in Florida
- The state of Florida has laws and regulations governing the prescribing authority of nurse practitioners, including the prescription of chronic pain medications.
- According to a study published in 2021 2, Florida APRNs (Advanced Practice Registered Nurses) are authorized to prescribe schedule II-IV drugs, including those used for chronic pain management, following legislative changes in 2017.
Chronic Pain Management
- Chronic pain is a complex condition that requires appropriate treatment, including pharmacological and non-pharmacological therapies 3, 4.
- The treatment of chronic pain often involves the use of opioids, NSAIDs, and other medications, which can have varying degrees of efficacy and adverse effects 3, 4.
- Nurse practitioners play a crucial role in managing chronic pain, and their prescribing authority can impact patient access to care 2.
Prescribing Chronic Pain Medications
- While the provided studies do not specifically address the prescribing of chronic pain medications by nurse practitioners in Florida, they do suggest that APRNs in Florida are authorized to prescribe schedule II-IV drugs, which may include medications used for chronic pain management 2.
- It is essential to note that the prescribing of chronic pain medications requires careful consideration of the patient's individual needs, medical history, and potential risks and benefits of treatment 3, 4.