This will depend on the specific circumstances and the S8 medicine you intend to prescribe or supply. These are listed on NSW requirements for approval to prescribe or supply Schedule 8 medicines.
No. An approval issued by the NSW Health Secretary is separate from the PBS authority issued by Services Australia.
A PBS Authority is a reference that the Commonwealth has agreed to subsidise the cost of a medicine to the patient. It does not mean that it is legal for a prescriber to prescribe it.
A NSW Health approval is a reference to an authority under the Poisons and Therapeutic Goods Act 1966, a legal requirement to prescribe or supply certain medicines. See NSW requirements for approval to prescribe or supply Schedule 8 medicines and certain restricted substances.
Firstly, you need to check if an approval is required for that medicine, see webpage Prescribe or supply a Schedule 8 medicine for pain or a Schedule 8 benzodiazepine.
Applications can be submitted online via SafeScript NSW. Alternatively, an application form can be completed and forwarded to the Pharmaceutical Services Unit, NSW Ministry of Health. Application forms are available at Application forms for approval to prescribe or supply.
No. Please refer to the FAQ response above for details on how to apply for an approval.
If you are planning to go on leave, the following options should be considered for your patient to continue taking the S8 medicine:
If you want to prescribe a medicine to your patient, and notice that SafeScript NSW shows an approval issued to another prescriber, you will need to contact that prescriber to discuss the ongoing care of the patient. SafeScript NSW will prompt you with an alert and not allow you to progress with your application unless the initial prescriber exits or cancels the approval for you to take over. You will then be able to apply for an approval to prescribe the medicine.
You need to ensure appropriate arrangements are in place for patient care to avoid duplication of treatment and the issue of prescriptions by different prescribers for the same monitored medicine.
The Poisons and Therapeutic Goods legislation prohibits a medical practitioner from self-administering any unregistered S8 medicine.
A prescriber can only self-administer a registered S8 medicine in an emergency for up to 7 days. An approval from the NSW Ministry of Health is required for treatment outside these conditions.
Refer to Guideline for self-treatment and treating family members and DIY medicine – the perils of self-prescribing for guidance from the Medical Council of NSW.
Destruction of a prescriber’s S8 medications can be carried out by an authorised inspector of the NSW Ministry of Health, Pharmaceutical Services, the police, or a community pharmacist.
A pharmacist working in a community pharmacy (not necessarily the original supplier of the medicines) may destroy a S8 medicine belonging to a prescriber either at the pharmacy or at the prescriber's practice.
Prescribers may find it convenient to make arrangements to destroy unwanted S8 medicines at their local pharmacy. If the medicines are to be destroyed at a pharmacy, the prescriber will need to take their drug register, as well as the affected medicines, to the pharmacy and witness the destruction . The pharmacist must record the destruction in the prescriber's drug register, including the date, and the pharmacist’s name and professional registration number. The name of the prescriber must also be entered in the drug register. Both the pharmacist and the prescriber must enter their signatures next to the entries. The pharmacist should not take possession of the medicines nor enter them into the pharmacy's drug register.
A pharmacist is not obliged to destroy medicines on request.
General practitioners and other registered medical practitioners are required to apply for an individual patient approval to prescribe a psychostimulant medicine (e.g., methylphenidate, dexamfetamine, lisdexamfetamine) to a patient for any indication. In most cases these applications will only be approved where the applicant is in a patient co-management or transfer of care arrangement with a relevant medical specialist.
Patients who may require S8 psychostimulant medicines should be referred to an appropriate specialist for assessment.
For more information, see Prescribe a psychostimulant medicine.
An approval to prescribe a S8 medicine is not transferable. General practitioners and other registered medical practitioners are required to apply for individual patient approval to prescribe a psychostimulant medicine to a patient for any indication. For further information, see How to apply for an approval to prescribe a psychostimulant medicine.
Nurse practitioners are not authorised under the Poisons and Therapeutic Goods legislation to prescribe or supply S8 psychostimulant medicines.
Advanced trainees in medical specialities such as paediatrics or psychiatry are required to apply for individual patient approval to prescribe a psychostimulant medicine. In most cases these applications will be approved when the trainee is co-managing the patient with a relevant medical specialist.
For more information, see Prescribe a psychostimulant medicine.
S8 medicines, such as opioids (e.g., oxycodone, morphine, fentanyl, etc.), are subject to misuse or abuse by some individuals.
If you deem a patient to be drug-dependent, it is illegal to prescribe a S8 medicine without prior written approval from the NSW Ministry of Health. For more information, see NSW requirements for approval to prescribe or supply Schedule 8 medicines.
You can also refer the patient to a community Drug and Alcohol Unit. For more information, contact the Alcohol and Other Drug Information Service (ADIS) on 1800 250 015, or refer to Contact information, support and treatment services.
Prescribers should exercise caution when patients request medicines that are subject to abuse, especially new patients. Any decision to prescribe should align with professional practice standards and be guided by sound clinical judgement that the treatment is appropriate for the patient's condition.
Requests for medications such as opioids and benzodiazepines might indicate that the patient is attempting to obtain medicines above medical need or that they may be drug-dependent.
SafeScript NSW can provide a prescriber with real-time information about a patient's prescription history for certain high-risk medicines. The Commonwealth's Prescription Shopping Information Service (PSIS)can also be contacted to obtain a summary of PBS subsidised medicines that have been supplied to the patient.
It may be inappropriate to prescribe a benzodiazepine to maintain a patient's dependence.
You may contact the DASAS Helpline, a free service to NSW health professionals, that can assist and provide you with advice on the diagnosis and treatment of patients with alcohol or drug issues. The DASAS is available 24 hours a day, 7 days a week.
Refer to Clinical guidance for withdrawal from alcohol and other drugs for the treatment of withdrawal from alcohol and other drugs such as benzodiazepines.
No. By law, a doctor may not issue a prescription for a medicine for a purpose that does not accord with recognised therapeutic standards of what is appropriate in the circumstances. Improvement of physical appearance is not a therapeutic purpose.
The patient should be counselled on the risks and harms associated with using anabolic steroids and other performance-enhancing drugs. Refer to anabolic steroids for more information.
The patient should also be advised that it is an offence to possess anabolic steroids that have not been prescribed for them.
In the case of an emergency, a prescriber may direct a community pharmacist via telephone, e-mail, or fax, to supply a Schedule 4 or Schedule 8 (S8) medicine, giving all the details required for a prescription, including the details (where required) of a NSW approval or Commonwealth authority that has been issued for the prescription. The prescriber must then immediately write a valid prescription and send it to the dispensing pharmacy as soon as practicable and within 24 hours. The prescriber must note on the prescription that a direction for dispensing was provided to the pharmacist via telephone, fax, or email.
It is an offence for a prescriber not to forward the written prescription within 24 hours.
If the pharmacist has not received the prescription within 7 days of the supply, they must report this to the NSW Ministry of Health.
Pharmacists must take special care to verify that a telephone order for a Schedule 4 Appendix D (S4D) or S8 medicine is genuine. They may use an independent source to obtain the prescriber's telephone number and call the prescriber to verify the request.
No, you should obtain medicines from a licensed wholesaler. An authorised prescriber can obtain scheduled medicines from a pharmacy only on an:
Medicines obtained in the name of a patient are the property of that patient, and any medicines left over after that patient’s treatment should not be supplied (or administered) to another patient.
No. A prescriber cannot buy wholesale quantities of scheduled medicines for general surgery use from a community pharmacy; the medicines should be purchased from a licensed wholesaler.
As a prescriber, you can write an emergency medicine order (not a prescription) to obtain small quantities of medicines from a community pharmacy for use in emergencies. For example, when it wouldn't be practicable to give a patient a prescription for an urgently needed medicine to have it dispensed at a pharmacy.
No. Prescriptions must be dated with the date they were issued. If you don't want the patient to have the prescription dispensed straight away, you can include in the body of the prescription the words: ‘do not dispense before (insert future date)’.
All persons engaged in the manufacture, distribution, sale, administration, or supply of Schedule 8 medicines must keep a drug register. Drug registers, as well as ward registers, can be purchased from the State Government printing contractor Finsbury Green.
A drug register can be ordered by contacting Finsbury Green by emailing nswhealth@finsbury.zohodesk.com.au.
All orders need to be paid for by Credit Card at the time of placing the order. The following registers are available for purchase, with a minimum order of 1 book:
Finsbury Green Help Desk may be contacted by telephone on 1800 515 222 but only after an order has been placed.
Drug registers may also be purchased from some pharmaceutical wholesalers and the Pharmaceutical Society of Australia. Subsidiary Drug registers for the dosing of methadone, Subutex, and Suboxone (each one has its own) are available from the NSW Pharmacy Guild on (02) 9467 7100.
Information is available online for the NSW Immunisation Program and the National Immunisation Program (NIP).
Information on vaccines can also be obtained by contacting Seqirus on 1800 008 275.