New WA S8 Prescribing Laws

Are you aware that on 30 January 2017, Western Australia’s new Schedule 8 (S8) prescribing laws came into force? This involves a new Code of Practice and changes to authority and reporting requirements. The changes are designed to better reflect routine practice. All practitioners who prescribe S8 drugs should be familiar with the changes.

As is the case in every State/Territory, WA has strict laws governing the prescribing of S8 drugs. S8 drugs include most opioids, stimulants, cannabinoids and some benzodiazepines. As of 30 January 2017, the new WA laws include revised reporting requirements and simplified authority requirements (some non-drug dependent patients on long term opioid treatment for pain will no longer require authority). WA Health Medicines and Poisons have released an updated S8 medicines prescribing code and information on prescription requirements. 

Real-time S8 prescription monitoring is being developed and is hoped to be in place in WA by late 2018. 

Important points

1. When considering prescribing S8 drugs to a patient, the first step to address is “Is this patient drug dependent/oversupplied?” Reporting of either drug dependent or oversupplied patients is required within 48 hours.

   [Drug Dependent Reporting Form] [Oversupplied Persons Reporting Form]

   A person who has over a period of time obtained, or obtained prescriptions for, quantities of drugs of addiction that are greater than is reasonably necessary for therapeutic use.

   Drug dependent	Oversupplied
   A person who has acquired, as a result of repeated administration of drugs of addiction or Schedule 9 poisons, an overpowering desire for the continued administration of a drug of addiction or a Schedule 9 poison.	A person who has over a period of time obtained, or obtained prescriptions for, quantities of drugs of addiction that are greater than is reasonably necessary for therapeutic use.

   
   

2. Authority is required [Authority form], typically with specific specialist support, before prescribing, when patients are:

   • aged <18 years; or
   • "drug dependent" or "oversupplied" patients (even if prescribing on hospital discharge); or
   • on opioid substitution treatment unless as per existing authority; or
   • known to have a history of substance abuse in the prior five years; or
   • on total daily dose over 90 mg morphine equivalents; [conversion calculator] or
   • on total daily dose over 45 mg immediate release morphine equivalents; or
   • going to be prescribed methadone/alprazolam/flunitrazepam; or
   • receiving injectable formulations of S8 drugs; or
   • likely to need S8 drugs for >30 days and a S8 treatment contract is not in place.

 

3. Significantly, patients treated for pain with S8 opioids who are not in the above categories do not need approval (previously patients who were not drug dependent required authority after 60 days of S8 supply). If prescribing opioid S8 drugs for pain for more than 30 days, you must have an S8 treatment contract in place.

 

4. The following general points are important, particularly for new patients:
   • Verify (where possible) a patient’s identity (a verified DOB is required for S8 scripts).
   • Contact the Schedule 8 Prescriber Information Service for a prescription history on (08) 9222 4424 (0830-1600 hrs) or, in the interim, the recommendation is to prescribe only enough S8 drugs to last a maximum of two days (or the next business day after this, during holiday periods).
   • Take a prescribing history; have a clear diagnosis and indication for S8 treatment; and be aware of ‘Red Flags’ (see the S8 Prescribing Code for more information).

This blog contains general information only. We recommend you contact your medical defence organisation or insurer when you require specific advice in relation to medico-legal matters.