Real time prescription monitoring

Prescription drug dependence and overdose, as well as misuse and diversion for non-medical use, are major public health concerns both in Australia and internationally.

Over the last decade, the annual number of unintentional drug-induced deaths has continued to rise in Western Australia. Opioids are the drugs most commonly associated with drug-induced deaths and pharmaceutical opioids, rather than heroin, are involved in a significant number of these deaths. Substance use disorder, whether associated with non-medical use of pharmaceuticals or illicit drugs,leads to negative health and social outcomes for effected individuals.

Across Australia, the number of overdose deaths has exceeded the road toll since 2014 (Australia’s Annual Overdose Report 2024 - Penington Institute (external site)). In Western Australia, 233 people died due to unintentional overdoses in 2022 while there were 174 road fatalities during the same year.

Real-time prescription monitoring systems, such as ScriptCheckWA, are one strategy to promote quality use of medicines and reduce the risks associated with opioids and other medicines that can result in dependency and be harmful in overdose.

Alerting prescribers and pharmacists to potential risks in real-time can help them make safer decisions before prescribing or dispensing a monitored medicine, and potentially reduce the risk of death caused by preventable overdose. 

Doctors, pharmacists and other prescribers of Monitored Medicines, such as nurse practitioners, may view records about their patients in ScriptCheckWA.

Authorised Department of Health officers can also access ScriptCheckWA, as part of their regulatory role.

All ScriptCheckWA users have to register to use the system and identity checks are part of the registration process. In addition, a log is created each time a registered user views a patient’s record in the system.

Multi-factor authentication is required for users to log on to ScriptCheckWA.

Medicines classified as drugs of addiction or Monitored Medicines, including controlled drugs (schedule 8 medicines) and schedule 4 monitored (schedule 4 reportable medicines) are monitored through ScriptCheckWA

Schedule 8 medicines

These medicines have been monitored by the Department of Health in Western Australia for many years, through the provision of dispensing records by all pharmacies across the state.

Schedule 8 medicines include:

• Opioids such as morphine, oxycodone and tapentadol
• Stimulant medicines such as dexamfetamine, lisdexamfetamine and methylphenidate
• Alprazolam and flunitrazepam
• Medicinal cannabis products that contain THC
• Methadone and buprenorphine used for opioid substitution treatment (OST, also known as the Community Program for Opioid Pharmacotherapy or CPOP).

Schedule 4 Monitored Medicines (Schedule 4 Reportable)

These are high-risk prescription only (Schedule 4) medicines described as ‘Schedule 4 reportable’ medicines in the Medicines and Poisons Act 2014 and are listed in the Medicines and Poisons Regulations 2016.

Schedule 4 Monitored Medicines include:

• All benzodiazepines in Schedule 4
• Codeine-based preparations in Schedule 4
• Gabapentin
• Pregabalin
• Quetiapine
• Tramadol
• Zolpidem
• Zopiclone. 

The data in ScriptCheckWA is information that forms part of the Drugs of Addiction Record, as detailed in the Medicines and Poisons Act 2014 (external site).

Information available to health practitioners about the medicines monitored through ScriptCheckWA includes:

• Details of prescriptions issued
• Details of prescriptions dispensed
• Regulatory authorisations issued to prescribers
• Alerts relating to high-risk criteria, such as whether a person has been prescribed high doses of opioids or is recorded as experiencing drug dependency.

Prescribers who prescribe Monitored Medicines and pharmacists who dispense monitored medicines are required to register for ScriptCheckWA. Health practitioners are only permitted to access information for patients who are a client of the health practitioner.