Psychiatrists Prescription Abilities

[opi8]

Can a psychiatrist prescribe S8 drugs to a patient in Australia?

 

[canarylove]

sounds like you have a psych or intend on getting a psych and if they can prescribe S8's you will try to wrangle a script!

 

[thestudent14]

This is all from the Drugs, Poisons and Controlled Substances Act 1981

20 What a licence, permit or warrant can authorise
(1) A licence authorises a person to do all or any of
the following—
(a) manufacture and sell or supply by wholesale
any Schedule 8 poison or Schedule 9 poison
other than heroin;

(d) sell or supply by wholesale any Schedule 8
poison or Schedule 9 poison other than
heroin;

(2) For the purposes of this Division, a registered
medical practitioner or a nurse practitioner
administers, supplies or prescribes a Schedule 8
poison to a patient for a continuous period if the
practitioner

(a) actually administers, supplies or prescribes
that Schedule 8 poison for that period; or

(b) supplies a quantity or quantities of a
Schedule 8 poison to the patient and instructs
the patient to take the drug for that period; or

(c) prescribes for the patient a quantity or
quantities of a Schedule 8 poison which, if
taken in accordance with the prescription,
would be taken for that period.

Record keeping in relation to sale or supply of drugs
of addiction
(1) A person who is licensed under this Part to
manufacture, sell, supply or distribute any
Schedule 8 poison or Schedule 9 poison must
record or cause to be recorded, in accordance with
subsection (2)—
(a) details of any Schedule 8 poison or
Schedule 9 poison obtained by the person;
and

Schedule 8 permit means a permit to administer,
supply or prescribe a Schedule 8 poison
issued by the Secretary under section 34A;

A registered medical practitioner or a nurse
practitioner who has reason to believe that one of
his or her patients is a drug-dependent person
must give a notification of drug-dependent person
to the Secretary if

(a) the patient requests or seeks prescription of a
Schedule 8 poison or a Schedule 4 poison
which is also a drug of dependence; or

(b) the practitioner intends to treat or is treating
the patient with a Schedule 8 poison or a
Schedule 4 poison which is also a drug of
dependence.

(3) A registered medical practitioner or a nurse
practitioner must apply to the Secretary for a
Schedule 8 permit if—

(a) the practitioner—
(i)
has reason to believe that one of his or
her patients who is not a drugdependent
person has been, or is
currently being, administered, supplied
or prescribed a Schedule 8 poison by
one or more other practitioners; and
(ii)
considers it is necessary to administer,
supply or prescribe a Schedule 8 poison
to or for that patient; and

(b) the total period of administration, supply or
prescription of a Schedule 8 poison to that
patient would be a continuous period greater
than 8 weeks, taking into account any period
of administration, supply or prescription
referred to in paragraph (a)(i) together with
the period of administration, supply or
prescription of a Schedule 8 poison to or for
that patient by the practitioner.

(4) An application for a Schedule 8 permit must be in
the prescribed form.
34A Schedule 8 permit

(1) On receiving an application under section 34, the
Secretary may issue a permit to a registered
medical practitioner or a nurse practitioner
authorising the practitioner—

(a) to administer, supply or prescribe a
Schedule 8 poison to or for a drug-dependent
person; or

(b) to administer, supply or prescribe a
Schedule 8 poison to or for a person other
than a drug-dependent person for a
continuous period greater than 8 weeks.

(2) A Schedule 8 permit must be in the prescribed
form.

(3) The Secretary may at any time amend, suspend or
revoke a Schedule 8 permit and any permit which
is suspended or revoked ceases to have effect.
34B Offence to administer etc. Schedule 8 poisons to
drug-dependent person
A registered medical practitioner or a nurse
practitioner must not at any time administer,
supply or prescribe a Schedule 8 poison to or for a
person he or she has reason to believe to be a
drug-dependent person unless the practitioner

(a) holds a Schedule 8 permit for that
administration, supply or prescription to or
for that person; or

(b) is otherwise authorised by or under this Act
to do so.
Penalty: 100 penalty units.
34C Offence to administer etc. Schedule 8 poisons to
person who is not a drug-dependent person

(1) A registered medical practitioner or a nurse
practitioner must not administer, supply or
prescribe a Schedule 8 poison to or for a person
who is not a drug-dependent person for a
continuous period greater than 8 weeks unless the
practitioner

(a) holds a Schedule 8 permit for that
administration, supply or prescription to or
for that person; or

(b) is otherwise authorised by or under this Act
to do so.
Penalty: 100 penalty units.

(2) Subject to subsection (3), unless otherwise
authorised by or under this Act to do so, a
registered medical practitioner or a nurse
practitioner must not administer, supply or
prescribe a Schedule 8 poison to or for a person
who is not a drug-dependent person without a
Schedule 8 permit if the total period of
administration, supply or prescription of the
Schedule 8 poison to or for that person would be a
continuous period greater than 8 weeks, taking
into account the total of—

(a) any period of administration, supply or
prescription of a Schedule 8 poison to or for
that person that the practitioner has reason to
believe has been, or is currently being,
administered, supplied or prescribed by one
or more other practitioners; and

(b) the period of administration, supply or
prescription of a Schedule 8 poison to or for
that patient by the practitioner.
Penalty: 100 penalty units.

(3) A registered medical practitioner or a nurse
practitioner who has applied for a Schedule 8
permit under section 34(3) is authorised to
administer, supply or prescribe a Schedule 8
poison to or for a person who is not a drugdependent
person in respect of whom the
application relates without a Schedule 8 permit for
the purposes of ensuring continuity of that
person's treatment until

(a) the Schedule 8 permit is issued; or

(b) the Secretary refuses to issue the permit.
34D Exception to Schedule 8 permit requirement—
specified medical conditions
Despite section 34C(1), a registered medical
practitioner or a nurse practitioner is authorised to
administer, supply or prescribe a Schedule 8
poison to or for a person who is not a drugdependent
person during a continuous period
greater than 8 weeks without a Schedule 8 permit
if

(a) the administration, supply or prescription of
that Schedule 8 poison is to treat that person
for a medical condition in the circumstances
(if any) specified by the Secretary in
accordance with section 35A; and

(b) the registered medical practitioner or the
nurse practitioner has given written notice of
that administration, supply or prescription to
the Secretary.

Drugs, Poisons and Controlled Substances Act 1981
No. 9719 of 1981
73

34E Exceptions to Schedule 8 permit requirement—
multiple practitioners at medical clinic

(1) Despite section 34B, a registered medical
practitioner or a nurse practitioner at a multiplepractitioner
clinic is authorised to administer,
supply or prescribe a Schedule 8 poison to or for a
drug-dependent person without a Schedule 8
permit if

(a) the treatment is provided at the multiplepractitioner
clinic; and

(b) a Schedule 8 permit has been issued to
another registered medical practitioner or
another nurse practitioner at that multiplepractitioner
clinic to administer, supply or
prescribe the Schedule 8 poison to or for that
drug-dependent person; and

(c) the administration, supply or prescription of
the Schedule 8 poison is carried out in
accordance with that permit.

(2) Despite section 34C(1), a registered medical
practitioner or a nurse practitioner at a multiplepractitioner
clinic is authorised to administer,
supply or prescribe a Schedule 8 poison to or for a
person who is not a drug-dependent person during
a continuous period greater than 8 weeks without
a Schedule 8 permit if

(a) the treatment is provided at the multiplepractitioner
clinic; and

(b) a Schedule 8 permit has been issued to
another registered medical practitioner or
another nurse practitioner at that multiplepractitioner
clinic to administer, supply or
prescribe the Schedule 8 poison to or for that
person; and

Drugs, Poisons and Controlled Substances Act 1981
No. 9719 of 1981
74

(c) the administration, supply or prescription of
the Schedule 8 poison is carried out in
accordance with that permit.

(3) Despite section 34C(2), a registered medical
practitioner or a nurse practitioner at a multiple
practitioner clinic is authorised to administer,
supply or prescribe a Schedule 8 poison to or for a
person who is not a drug-dependent person
without a Schedule 8 permit in the circumstances
set out in section 34C(2) if

(a) the treatment is provided at the multiplepractitioner
clinic; and

(b) a Schedule 8 permit has been issued to
another registered medical practitioner or
another nurse practitioner at that multiplepractitioner
clinic to administer, supply or
prescribe the Schedule 8 poison to or for that
person; and

(c) the administration, supply or prescription of
the Schedule 8 poison is carried out in
accordance with that permit.
34F Exception to Schedule 8 permit requirement—
patients in prisons, aged care services and hospitals
Despite sections 34B and 34C, a registered
medical practitioner or a nurse practitioner is
authorised to administer, supply or prescribe a
Schedule 8 poison to or for a person without a
Schedule 8 permit if that person is

(a) a prisoner being treated in a prison for the
period in prison and a period not exceeding 7
days after that prisoner's release from
custody; or

(b) a resident being treated in an aged care
service; or

(c) an in-patient being treated in a hospital.
s. 34F
S. 34F
inserted by
No. 17/2008
s. 8.

Drugs, Poisons and Controlled Substances Act 1981
No. 9719 of 1981
75


35 Offence not to comply with Schedule 8 permit
A registered medical practitioner or a nurse
practitioner must not administer, supply or
prescribe a Schedule 8 poison to or for one of his
or her patients in respect of whom a Schedule 8
permit has been issued—
(a) other than for the period specified in the
permit for that administration, supply or
prescription; or
(b) in excess of the quantity specified in the
permit

I know it's alot to sift through, but it's worth having a read through anyway.
Hope this helps.

 

[opi8]

sounds like you have a psych or intend on getting a psych and if they can prescribe S8's you will try to wrangle a script!

How imaginative of you, i bet it took you a while to think of that. I'm actually asking for a friend, who asked me to ask BlueLight, believe it or not. I am happy with my own psych who has prescribed me what I wanted, and what works for me, personally.

Regardless, thank you thestudent14, I will have a read when I'm not so drunk and hopefully garner some kind of understanding, it doesn't look like it's a simple yes or no answer.

 

[Mr Blonde]

^ Yes they can. In fact, in some states (WA is one I think) only psychiatrists and certain other health professionals can prescribe S8 stimulants, whilst only GP's and other appropriate, licensed professionals can prescribe S8 opioids or sedatives.

I'd be surprised if there were many psychiatrists without the ability to Rx S8 medications that are useful in their profession.

 

[opi8]

Of course Mr Blonde, I wasn't really thinking straight.

I should have been more specific, can a psych prescribe S8 opiates in Victoria to a patient who has been or is on opiate maintenance?

 

[Christ!]

I should have been more specific, can a psych prescribe S8 opiates in Victoria to a patient who has been or is on opiate maintenance?

Not sure about that one...sounds like a recipe for disaster though

Pretty sure doctors/psychiatrists can look on some special website to check what other S8 scripts you've been prescribed. Not certain of this though it might only be some states that have this setup.

Simple answer (I'm guessing here) - Yes, I believe they can. However there might be certain regulations surrounding this depending on your state.

For example - Someone on opiate maintenance diagnosed with ADD looking for treatment must get positive diagnosis from 2 psychiatrists and they must both agree that the best option would be to prescribe stimulants (dex, ritalin). This is in SA, not sure about elsewhere. Often if there's substance abuse problems in the past S8 prescriptions might be daily/weekly pickup...or something like that which I reckon is a good idea.

Someone on opiate maintenance getting prescriptions for other S8 opiates would be discovered by the DDU I'd guess. Pays to be honest I find, or your friend might find himself on a doctor shoppers list with no one willing to prescribe him controlled meds ever again.

 

[opi8]

To be perfectly clear, this isn't me. I've never been on opiate maintenance, thankfully.

The person in question was not trying to deceive anybody either, he has heard conflicting opinions about the ability for psychiatrists to prescribe S8 opiates, especially to someone on opiate maintenance like him, and he asked me to ask here on his behalf as he's not computer literate.

Thanks for your thoughts.

 

[Divine Moments]

My gut reaction is no, but I'm not sure. I looked it up in the therapeutic guidelines, and, despite a chapter on 'Legal aspects of prescribing opioids', it doesn't make it clear who can and cannot prescribe them (only who can and cannot be prescribed them and who needs to be notified). For someone on OMT I assume their usual prescriber already obtained authority - why do they want a psych to script it now?

 

[Mr Blonde]

From what I've read, I'm going to lean towards no. It does vary from state to state, but psychiatrists probably aren't allowed to prescribe opioids in most cases. A GP would have to do that, probably in consultation with your opioid maintenance provider.

 

[Christ!]

To be perfectly clear, this isn't me. I've never been on opiate maintenance, thankfully.

Sorry man, didn't mean to do that. I believe you completely. My friends tend to come to me for any drug related questions as well Yep, opiate maintenance is no fun.

Also - Divine moments and Mr B probably know better than me.

My memory is so bad...but I do remember hearing somewhere they could prescribe anything (within reason). Something like they can prescribe it for 2 weeks and if it warrants longer treatment than that they have to get authority? If the psychiatrist is working with addiction they can get authority to prescribe bupe, methadone which are S8 opiates technically. Maybe if they're working with pain patients they can prescribe others? I'm not really sure and should have made that more clear in my first post. I still think they 'can' but it'd be rare.

My psychiatrist prescribed diamorphine (heroin) to addicts when he worked in the UK...not really related but interesting fact! Who knows how long ago that was though.

 

[cheap L]

psychiatrists are medical doctors first, psych's second, although some forget that. they can prescribe opiates.
however to prescribe to someone who has been previously opiate dependent, you must get an authority for that script. only one person can prescribe it and hold that authority.
i'm still learning. but they are the rules for vic.

 

[lagger]

Umm a gynacologist can prescribe Oxy really but will it come back to them at one stage/

 

[Mr Blonde]

Yes if doctors are prescribing meds that are considered outside their 'jurisdiction', for lack of a better term, then it does get followed up on.

I've heard a few interesting stories of specialist surgeons hooked on opioids getting caught out by a pharmacist who reported them. The pharmacist was told to keep quiet about it and let the Board talk to the doctor and make an 'arrangement'... because they didn't have anyone else who could do this guy's job at that time.

This would have been about 20 years ago or so, things have changed since then I imagine.

 

[Mr. Squiggle!]

Psychiatrists cannot prescribe Schedule 8 drugs, except for Dexamphetamine/Ritalin and sometimes Subuxone (only if their pt is an opioid addict with a long history of abuse/misuse).