Permits for drug dependence

Drugs of dependence have properties that make them addictive and there is a high potential for misuse. Broadly, drugs of dependence are opioids, sedatives, anabolic steroids and stimulants. When prescribed and used appropriately, these drugs can help achieve a patient’s therapeutic needs and goals. However, these medicines present unique challenges for doctors and patients.

Rules associated with Schedule 8 medications exist to promote their safe and proper use. GPs should be aware of these rules because they have a legal obligation to prescribe in a way permitted by law. There is legislation in each state and territory that governs the prescribing and supply of Schedule 8 medications (Table 1). GPs can also contact their medical defence organisation or local health department if they have questions about the legislation or their legal requirements regarding the prescription and supply of medications (Table 1). 

There may be requirements to obtain a state or territory permit, approval or authority for the ongoing supply of drugs of dependence for more than two months to non-drug-dependent patients. GPs must obtain an authority, approval or permit to prescribe a drug of dependence for drug-dependent patients. 

When prescribing a Schedule 4 or 8 drugs to a resident, particularly one who is drug dependent, GPs need to notify the RACF staff so that this information can be included on the resident’s medication chart. 

Most medicine used in residential aged care services is supplied for administration to specific patients, in the same way the medicine is supplied for a person in private residential accommodation. 

If a GP observes excessive use of Schedule 4 or 8 drugs among residents, it is important that the GP develops a plan to reduce level of medication needed in those circumstances. The GP may involve other specialist services if required. 

State and territory departments and government-funded drugs of dependence units provide information for medical practitioners in each state and territory. 

Legislation for prescribing Schedule 8 medications in Western Australia

The Schedule 8 Medicines Prescribing Code governs the prescribing of Schedule 8 (S8) medicines in Western Australia. The Western Australia Department of Health authorises any prescription of S8 benzodiazepines or S8 opioid treatment that meets any of the criteria set out in Section 2.5.1 of the Code for each individual patient. Practitioners are required to contact the Schedule 8 Prescriber Information Service (available by telephone on 08 9222 4424) to obtain advice on a patient’s prescribing and dispensing history prior to prescribing any of the listed medicines under the Code. Information about the criteria and requirements are available here. 

See Part A: Medication management for further information about prescribing medications.

See Part A: Pain regarding the pharmacological management of pain.

Different Australian states and territories have implemented a national real-time prescription monitoring (RPTM) system. These systems allow medical practitioners and other health professionals to view recent records of monitored medicines that are dispensed to patients. These systems aim to support safer clinical decision making and reduce harm and preventable deaths in the community. 

In some states and territories, it is mandatory to check the RTPM system before prescribing. GPs should ensure they are aware of and comply with the requirements of the jurisdiction in which they practise. A summary of laws and regulations can be found in the RACGP resource, Prescribing drugs of dependence in general practice – clinical governance framework. 

A national RTPM system is dependent on other states and territories entering the National Data Exchange and the existence of suitable agreements on data sharing and privacy. 

A link to the different monitoring systems is provided in Table 2. 

• Drugs of Dependence Unit, SA Health: Health practitioner’s legal obligations under the Controlled Substances Act 1984 and its regulations
• RACGP: Prescribing drugs of dependence in general practice