Prescribing Controlled Substances FAQs

What Board rules govern the prescribing of controlled substances?

540-X-4, Alabama Controlled Substances Certificate
540-X-12, Qualified Alabama Controlled Substances Certificate (P. A.)
540-X-17, Guidelines and Standards for the Utilization of Controlled Substances for Weight Reduction
540-X-18, Qualified Alabama Controlled Substances Certificate (CRNP/CNM)
540-X-19, Standards for Pain Management Services
540-X-20, Limited Purpose Schedule II Permit (P. A./CRNP/CNM

All of these rules can be accessed through the Alabama Administrative Code web site

Which calculator is recommended to determine Morphine Milligram Equivalencies (MMEs)?

The Board does not recommend a particular calculator. Use the one that you prefer. Below are links to a variety of MME calculators. This list is not exhaustive nor is it an endorsement of these sites:

Epocrates (requires sign in)
Centers for Medicare & Medicaid Services
Lexicomp (requires sign in)
OpioidCalc (free app: Android iTunes)
Washington State Agency Medical Directors' Group

Opioid dose reference guide with indicators of PDMP check is required

What are examples of validated risk-assessment tools?

BRI - Brief Risk Interview (free download at

DIRE - Diagnosis, Intractability, Risk, Efficacy score (link to .pdf copy)

ORT - Opioid Risk Tool (link to .pdf copy)

PMQ - Pain Medication Questionnaire (link to download a copy)

SOAPP - Screener and Opioid Assessment for Patients with Pain (link to a copy; info about use and fees)

SOAPP-R - Screener and Opioid Assessment for Patients with Pain - Revised (link to a copy; info about use and fees)

BRQ - Brief Risk Questionnaire (free download at

What is the CME requirement for ACSC holders?

Effective Jan. 1, 2018*, all Alabama Controlled Substances Certificate holders will be required to obtain two (2) AMA PRA Category 1(TM) credits every two years in the areas of controlled substance prescribing practices, recognizing signs of the abuse or misuse of controlled substances, or controlled substance prescribing for chronic pain management.  This requirement is interpreted to encompass credits earned in the calendar year 2018 and forward.

*Pending review of Rule 540-X-4-.09 by legislative committee; estimated effective date of Rule is Mar. 9, 2017.

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