Prescribers should recognise and work within the limits of their competence and scope of practice.
The prescribing of Monitored Medicines is limited to lawful practice of the health practitioner, any inherent professional scope or limitations imposed by the respective National Board, and the specific limitations of the Code (PDF 2MB). To be eligible to prescribe a Monitored Medicine, a prescriber’s professional registration must not have conditions or undertakings relevant to the prescribing of medicines.
The Code takes a risk-based approach to the regulation of Monitored Medicine prescribing. In certain circumstances, prescribing may:
- not require interaction with the Department of Health (the Department);
- require prescribers to carefully document a plan to mitigate harms associated with these medicines;
- require authorised prescribers to notify to the Department that they are treating a particular patient;
- require written authorisation from the Chief Executive Officer (CEO) before prescribing can commence.
Outlining important general conditions and recommendations, Part 1 of the Code is applicable to the prescribing and dispensing of all Monitored Medicines.
Before commencing treatment with Monitored Medicines
Prior to prescribing a Monitored Medicine, in line with Good Medical Practice: a code of conduct for doctors in Australia, it is recommended that the prescriber:
- assesses the patient, taking an accurate medical history (including medication and substance history) and undertaking clinical examination and investigations as appropriate.
- makes responsible and effective use of available resources, such as ScriptCheckWA (or the Monitored Medicines Prescriber Information Line) in combination with product information, recommendations, and best-practice guidelines that are current, approved, and published.
- considers the balance of benefit and harm in management decisions.
- has a clear diagnosis and indication for treatment. and
- formulates, implements, and documents an appropriate management plan, which considers all available treatment options including non-pharmacological strategies, regular review, mitigation strategies where there is a risk of overdose, diversion, or substance use disorders, and the need for a Treatment Contract (Word 415KB).
Notifications of stimulant induced psychosis
A psychiatrist who makes a diagnosis of stimulant induced psychosis in respect of a patient must notify the CEO. The notification must be in writing, in the approved form, and must be forwarded to the Department within 72 hours of making the diagnosis.
Written authorisation from the CEO is required to prescribe an S8 stimulant medicine or medicinal cannabis product for a person with a current, or prior, history of psychosis. The treatment must be medically indicated.