Authority (CNS or S28c) to prescribe or supply psychostimulant medicines

This page replaces:

  • TG190/7 Criteria for the management of medication for Attention Deficit Hyperactivity Disorder (ADHD) in adults, and
  • TG181/12 Criteria for the management of medication for Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents.

An authority or approval is required to prescribe a psychostimulant medicine

Under the Poisons and Therapeutic Goods legislation, an authority or approval from the NSW Ministry of Health is required to prescribe or supply a psychostimulant medicine.

A prescription for a psychostimulant medicine must be endorsed with an authority or approval number for it to be valid for dispensing.

Information on these requirements can be found at Prescribe a psychostimulant medicine.

The CNS and S28c authorities have been replaced with a class authority

Prior to 13 November 2023, authorities were issued by the Ministry of Health to individual psychiatrists, paediatricians, neurologists and some general practitioners to prescribe or supply psychostimulant medicines for ADHD treatment to any patient, subject to conditions. These authorities were issued:

  • with a reference number prefixed with ‘CNC’, or ‘S28c’ for use when endorsing prescriptions issued under this authority
  • with a condition requiring compliance to the following Ministry publications as applicable:
    • TG181 - a document informing paediatricians, psychiatrists, child & adolescent psychiatrists, neurologists, other designated prescribers (ODPs) and general practitioners about the criteria for obtaining authorisation to prescribe or supply psychostimulants for ADHD.
    • TG190 – a document informing psychiatrists, neurologists and general practitioners about the criteria for obtaining authorisation to prescribe or supply psychostimulants as treatment of ADHD.

From 13 November 2023  a Class authority issued by the Ministry of Health has replaced the CNS and/or S28c authorities. The class authority authorises any psychiatrist, paediatrician, and neurologist to prescribe or supply psychostimulant medicines for the treatment of ADHD in a non-drug dependent person, hence improving patient access to these medicines.

Authority requirements for prescribing or supplying psychostimulant medicines

Psychiatrists, paediatricians, and neurologists are requested to use the Class authority to prescribe or supply psychostimulant medicines to treat ADHD in non-drug dependent patients. These prescribers are requested to endorse prescriptions issued under this authority with the class authority number 'CA2023'. For more information see Prescribe a psychostimulant medicine.

To allow for continued access to psychostimulant medicines by patients of authorised practitioners, the 'CNS' or 'S28c' authorities will continue to remain valid unless otherwise cancelled or expired. Conditions previously listed in the CNS and S28c authorities, including compliance with the publications TG181 and TG190 have been replaced with the following conditions:

  • The medical practitioner authorised under a CNS or S28c authority must issue a prescription for psychostimulant medicines dexamfetamine, lisdexamfetamine or methylphenidate only for the purpose of the treatment of a person for ADHD.
  • The medical practitioner authorised under a CNS or S28c authority must directly supply dexamfetamine, lisdexamfetamine or methylphenidate only for the purpose of testing the suitability of the person to undergo a course of medical treatment involving these medicines for the treatment of ADHD.
  • The CNS or S28c authority does not authorise the issue of a prescription for, or supply to, a person who is a drug dependent person.
  • The medical practitioner authorised under a CNS or S28c authority must issue a prescription for, or supply, dexamfetamine, lisdexamfetamine or methylphenidate only within their lawful scope of practice, in accordance with all applicable standards, codes and guidelines, and within treatment protocols substantiated by scientific evidence and any approved product information.
  • The CNS or S28c authority does not authorise issue of a prescription for, or supply to, a person above the following daily dose limits:
    • dexamfetamine 50mg
    • lisdexamfetamine 70mg
    • methylphenidate 108mg.

Please note that the above requirements are the same as the conditions listed in the Class authority.

Definitions

Attention Deficit Hyperactivity Disorder or ‘ADHD’ means a diagnosis meeting the criteria in the:

‘Drug dependent person’ has the same meaning as in section 27 of the Poisons and Therapeutic Goods Act 1966. A drug dependent person means a person who has acquired an overpowering desire for the continued administration of such a drug as a result of repeated administration of:

Current as at: Friday 28 June 2024
Contact page owner: Pharmaceutical Services