Drugs of dependence
Drugs of dependence are prescription medicines with a recognised therapeutic use but also a higher potential for misuse, abuse, and dependence.
Many of these areSchedule 8 medicines (also known as controlled drugs), while some are higher risk Schedule 4 medicines (referred to as S4 Reportable Medicines) – together these are referred to as Monitored Medicines.
Monitored medicines have important therapeutic uses such as:
- treatment of severe pain
- management of attention deficit hyperactivity disorder (ADHD).
Monitored medicines are monitored through ScriptCheckWA, Western Australia’s real-time prescription monitoring system. Authorised prescribers and pharmacists involved in your care can access your prescribing and dispensing history for these medicines.
Schedule 8 medicines
The prescribing, storage and dispensing of Schedule 8 medicines is subject to a greater level of control than any other prescription-only medicines.
Some of the more commonly prescribed Schedule 8 medicines include opioids, stimulants and most medicinal cannabis products:
Opioids
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- morphine
- oxycodone
- fentanyl
- buprenorphine
- methadone
- tapentadol
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Stimulants
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- dexamfetamine
- lisdexamfetamine
- methylphenidate.
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Medicinal cannabis
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Most medicinal cannabis products are S8 medicines.
Products only containing cannabidiol (CBD, the non-psychoactive cannabinoid)are S4 medicines, also known as prescription only medicines.
The Poisons Standard (external site) allows “cannabidiol only” medicinal cannabis products to also contain very low levels of THC – up to 2 percent of the total cannabinoid content.
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Schedule 4 reportable medicines
These are Schedule 4 medicines which are considered to have a higher risk of abuse, misuse and physical or psychological dependence and include:
- all benzodiazepines in S4 (eg. temazepam, diazepam)
- codeine-based preparations in S4
- gabapentin
- pregabalin
- quetiapine
- tramadol
- zolpidemzolpiclone
What do I need to know about Schedule 8 medicine prescriptions?
A prescription is written by your doctor, dentist or nurse practitioner for the use of Schedule 8 medicines for the treatment of your medical condition.
Your doctor, dentist or nurse practitioner is only able to prescribe one Schedule 8 medicine per prescription. This prescription is only valid for 6 months.
Your doctor must ensure that the prescription is a valid Schedule 8 prescription and meets the appropriate legislative requirements.
These requirements are met by providing:
- your date of birth
- specific instructions for use
- the interval between dispensing repeat prescriptions.
Your pharmacist will ensure all legislative requirements have been met when you have your Schedule 8 prescription filled. This may mean a longer waiting time when collecting your prescriptions.
If your doctor or nurse practitioner has requested a repeat of your Schedule 8 medicine, the repeat interval will be specified. This determines when you can collect your next medication.
Your pharmacist cannot dispense a Schedule 8 repeat prescription earlier than the specified date.
All handwritten and computer-generated prescription repeats of Schedule 8 medicines must be kept at the same pharmacy that dispensed the original prescription. Electronic prescriptions (external site), as defined by the Australian Digital Health Agency (not the scanned version of a paper prescription), are excluded from this requirement and these repeats may be dispensed at any pharmacy in WA.
Why has my doctor asked me to see a pain specialist?
Strong pain relievers, also known as opioid Schedule 8 medicines, play an important role in the management of pain.
To make sure you achieve the best health outcomes, while minimising adverse effects, a review from an appropriate specialist is often required.
The Department of Health has produced a prescribing code for Monitored Medicines. This means doctors or other health professionals prescribing Monitored Medicines will need to refer a patient to an appropriate specialist when a patient’s treatment with opioids meets any of the high risk criteria.
Why can't my doctor prescribe for me?
Doctors must follow the rules on prescribing. Sometimes they have to submit an application to the Department of Health to prescribe, and receive an authorisation, before they can commence or continue prescribing.
The Department of Health may also require additional information from doctors prescribing Schedule 8 medicines before they give an authorisation.
This information can include:
- consultant reports
- urine drug screens
- reports from drug treatment providers.
The doctor can phone the Department of Health to discuss the progress of any application. This may include finding out if any additional information is required before the application can be processed.
The Department will work with the doctor to get the best result as quickly as possible.
You can talk to your doctor to find out the progress of an application.
Why have I been asked to sign an treatment contract?
Your doctor is required to obtain authorisation from the Department to prescribe strong pain medicines (opioid Schedule 8 medicines).
You are asked to sign a treatment contract to make sure you understand what is expected from you while you take these medicines.
It is your responsibility to make sure the medicines are used appropriately and according to the authorisation obtained by your doctor.
A treatment contract is an informed agreement between you and your doctor. You will be asked to only obtain prescriptions for the S8 medicines from your authorised doctor and to keep to the dosages prescribed, to avoid oversupply.
See Treatment Contract for the use of a Schedule 8 medicine (Word 390 KB) for an example.
Your doctor may use their own form of a treatment contract.
What is the record of drug dependent persons?
How will I be affected by having my name recorded?
Being recorded as a Drug Dependent Person relates to your medical treatment only.
If you require a prescription for a Schedule 8 medicine (strong pain medicine, stimulant or medicinal cannabis) your doctor is required to make an application to the Department of Health before prescribing for you.
If you require a prescription for a Schedule 4 reportable medicine your doctor will be required to document a plan to mitigate potential harms associated with these medicines with strategies such as staged supply, treatment contract or limiting supply from a single pharmacy.
Being on the record does not stop a health professional administering Schedule 8 or Schedule 4 reportable medicines to you in an emergency (such as in hospital).
Your information is only provided to health professionals who are involved in your treatment.
Information on the record is not available to your employer, police, or other agencies.
How can I get my name off the record?
Your details will be automatically removed from the record provided there has been no direct or indirect contact with the Department of Health relating to your use of a drug of addiction for at least 5 years since the initial report.
‘Contact’ includes having been prescribed S8 medicines, CPOP dosing and other enquiries relating to access to drugs of dependence.
Your doctor can apply, on your behalf, to have your name removed from the record, provided you have neither used any illicit drugs nor misused any prescribed S8 medicines for at least two years. You will be required to have certain medical tests as part of this process. The doctor must have been treating you for at least two years. Your doctor can call the Prescriber Information Service at the Department for guidance about this process.
You can apply to have the record about yourself amended or removed. You will need to provide evidence to support your request. If the reason you want the record about you removed is because you have been neither used any illicit drugs nor misused any prescribed S8 medicines for at least two years, it is recommended you ask your doctor to apply on your behalf (see above). Your request needs to be made in writing and mailed to:
The Chief Executive Officer
Medicines and Poisons Regulation Branch
Department of Health
PO Box 8172
Perth Business Centre WA 6849
Your request must be accompanied by certified copies of documents supporting your identity, which include photographic identification and your address. For details see Evidence of Identity Requirements (PDF 232KB).
Scanned copies and photocopies of certified documents are not acceptable. This means applications cannot be emailed.
Please contact the Department of Health on 9222 6883 for further advice.
Who should I talk to about my child's dependency issues?
The Parent and Family Drug Support Line (external site) is a 24 hour, confidential telephone service for anyone concerned about a loved one’s substance dependency issues. You can contact this service on 9442 5050 or toll free on 1800 653 203.
What should I do if I see somebody selling drugs medicines?
If you see somebody selling drugs/medicine on the street, the police should be notified on 131 444. To report anonymously, you can contact Crime Stoppers on 1800 333 000 or make a report online (external site).
You can report the illegal sale of prescription medicines to the Medicines and Poisons Regulation Branch at the WA Department of Health on 9222 6883.
Last reviewed: 12-12-2024
Acknowledgements
Medicines and Poisons Regulation Branch
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.