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  • AADD Moderators: swilow | Vagabond696

burprenorphine off-label indications

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doctordog

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Feb 13, 2011
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Hi -- I was wondering if anyone knew whether it was legal to prescribe buprenorphine off-label for psychiatric disorders in Australia? I've done a bit of research online, but can't find a clear cut answer.

Thanks
 
I know nothing about the laws in Australia. I do know that in the US (speaking as a nurse for 20 years) that it is not illegal to prescribe meds off label. The issues that come up with this practice though is ones insurance generally will not pay for it and if it is a scheduled drug (narcotic) you might have some problems with the DEA (Drug Enforcement Agency)..the doctor might have some trouble with them that is..unless they have a really, really good reason for doing it.

"Buprenorphine has also been found to relieve refractory depression, but this particular use has never been approved by FDA. Refractory depression is depression that has not responded to other treatments. Some patients, who suffered from depression in the past, have experienced relief of symptoms on buprenorphine. (Bodkin,1995)"

http://www.naabt.org/faq_answers.cfm?ID=10

I know that here in the US there are a few laws that specifically regard the prescribing of bupe. This is because only doctors that have taken a certification class can prescribe it for opiate/opioid abuse treatments (which is ridiculous). But the above website talks about a lot of different things regarding the med..of course regarding the legal issues it applies to the US.

Hope it helps some.
 
do a quick google for the mims. the info should be available to the general public. i no longer have login details to access the full details otherwise i would check.

there have been claims in the other drugs forum, by americans, that have been prescribed off label as an antidepressant. only like two accounts ive read after coming here near 10yrs.
 
missmeyet: Australia is comparatively far stricter than the US when it comes to prescribing regulations, which is why it wouldn't surprise me if an off-label indication was somehow not permitted The only thing I've been able to find is prescribing bup to pregnant opiate addicts, which supposedly counts as 'off-label' use and is up to the discretion of the practitioner.

I have severe, treatment-resistant OCD and would love to try it, but I'm guessing it won't be permitted.

tentram: I found the official mims website, but don't have access. When I googled mims + australia + buprenorphine, nothing came up.
 
have a search on the mims site. alternatively a doctor can inform you.
 
www.mimsonline.com.au doesn't let you search without login details..

I tried to bring up opiate-based drugs to a GP once and he got angry and said any off-label use is strictly illegal, but he seemed kinda like a reactionary tight-ass, so I didn't completely buy it. If I meet another decent doctor, I'll ask, but in the meantime if anyone knows, please chime in.
 
you could try ringing a dr anonymously, i guess. but im sure searching an appropriate website would yield the right answer. im personally drawing a blank right now. given i am a little incapacitated, sorry.
 
youre a gem around this place, missmeyet? :) you do good work in bdd and od and added bonus is being a nurse!
 
As far as I know in oz , bupe is only rx'd for pain and ORT, it might depend on state but a regular GP had to notify by phone a certain authority mentioned my name , my condition and amounts of bupe to be rx'd to get the OK before the script could be written.
Even if a GP can legally rx you bupe for off-label use I seriously doubt you would find one who would be willing to do so. Asking a doc (especially one you don't have a history with) for a specific strong opiate without it being your usual med is the best way to get shown the door and treated like a junky, doctors prescribe for you , you don't prescribe for yourself.
It's your body and whatnot but tha'ts just how it works.
Best thing you can do is find a good regular GP, build up a bit of a relationship and then you can start discussing treatment issues involving controlled drugs.

Are you already an opiate user, if not I wouldn't recommend going down that path, you might find an opiate addiction a worse affliction than your ocd.
 
oldirtybizza said:
As far as I know in oz , bupe is only rx'd for pain and ORT, it might depend on state but a regular GP had to notify by phone a certain authority mentioned my name , my condition and amounts of bupe to be rx'd to get the OK before the script could be written.
Click to expand...

Ah okay, when my psychiatrist used to prescribe Dexedrine, he'd similarly have to call for an authority prescription.

Even if a GP can legally rx you bupe for off-label use I seriously doubt you would find one who would be willing to do so. Asking a doc (especially one you don't have a history with) for a specific strong opiate without it being your usual med is the best way to get shown the door and treated like a junky, doctors prescribe for you , you don't prescribe for yourself.
It's your body and whatnot but tha'ts just how it works.
Best thing you can do is find a good regular GP, build up a bit of a relationship and then you can start discussing treatment issues involving controlled drugs.
Click to expand...

The GP I asked was my regular GP at the time, though he always treated me somewhat weirdly. I'm being referred to a new psychiatrist soon and was thinking about bringing up the idea (not during my first appointment, but at some point possibly).

Are you already an opiate user, if not I wouldn't recommend going down that path, you might find an opiate addiction a worse affliction than your ocd.
Click to expand...

No, I'm not an opiate user, but OCD has made my life a living hell for 8 years and I'm becoming increasingly suicidal (not imminently so, but more in a resigned-to-my-fate kind of way). Conventional psychiatric treatment has done nothing for me. It seems like a lesser-of-two-evils insofar as a lot of people report buprenorphine being superior to other ADs in terms of the mood boost, and I've heard the withdrawal can be manageable. At this point, I would quite seriously take a mild opiate addiction over my natural state.
 
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