Psychostimulants: do you know the rules?

Are you aware of your obligations regarding the supply of psychostimulants? PDL NSW has issued an update…

PDL receives numerous reports and queries relating to the specific rules on correctly prescribing and dispensing psychostimulants in NSW.

As a health care professional, you are responsible for complying with the NSW Poisons and Therapeutic Goods Regulation 2008. It is very important that all pharmacists are aware of their obligations to ensure prescriptions comply with the legislation and the prescriber is authorised to prescribe a psychostimulant.

The information below is available from the NSW Health website and explains some aspects of prescribing these medicines.

The following substances must not be supplied by a pharmacist unless the authority reference number is shown on the prescription (in accordance with clause 90 of the NSW Poisons and Therapeutic Goods Regulation 2008):

  • Dexamfetamine;
  • lisdexamfetamine (Vyvanse®); and
  • methylphenidate (Concerta®, Ritalin®, Ritalin LA®).

Note: An authority issued to a prescriber by the NSW Ministry of Health is separate to an authority required from Medicare Australia for a patient to receive a PBS subsidised medicine.

A medical practitioner may only prescribe a psychostimulant with the prior approval of the NSW Ministry of Health. All prescriptions written for dexamfetamine, methylphenidate or lisdexamfetamine, presented for dispensing must be endorsed with one of the following:

CNS ********** (i.e., unique number for prescriber), or

S28c ********** (i.e., unique number for prescriber), or

Ref. No. AU ****** (i.e., unique number for prescriber specific for each patient).

A prescription for a psychostimulant that is not endorsed with one of the above numbers CANNOT lawfully be dispensed, and the prescriber should be contacted to confirm the authority reference number.

If the prescriber has omitted to include the NSW authority to prescribe the medicine, the prescription should be returned to the prescriber for endorsement.

If the doctor does not have approval to prescribe the medicine, the prescription is invalid, and the prescriber should contact the Duty Officer at NSW Health Pharmaceutical Services to seek an authority.

These requirements are in addition to any PBS authority requirements and therefore apply to ALL prescriptions for dexamfetamine, lisdexamfetamine or methylphenidate, including non-PBS or ‘private’ prescriptions.

Dentists, nurse practitioners, midwife practitioners or veterinary practitioners may not prescribe or supply the substances specified above in the normal practice of their profession. (An exception is a veterinary practitioner may supply or administer methylphenidate tablets for animal treatment).

There are exemptions for hospital inpatients which are explained on the NSW Health website.

For immediate advice and incident support, members can call PDL on 1300 854 838 to speak with a Professional Officers. PDL supports its pharmacist members 24/7, Australia-wide.

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  1. Steven Julius

    Sounds easy in theory and I’m sure it works fine in Sydney. In regional areas or near the borders though where the only specialists are interstate this requirement is unrealistic and overcomplicated.

    I can’t say how many times I’ve had to try to explain this to an overstressed parent or an interstate specialist who shouldn’t be beholden to it. This requirement is hurting people. One example with the specialist now using phone appointments due to COVID is charging $180 a phone call.

    The NSW govt. should alter or remove this requirement or start paying us for training prescribers. Or compensate us for lost scripts dispensed and loss of customers because the easiest solution is to have the patient drive interstate. The drugs are still in NSW. It’s all a bit short-sighted.

    • Jarrod McMaugh

      not necessarily short sighted, but outdated…. many of these requirements were for a time when travelling out of state for a specialist etc wasn’t feasible.

      There is a need to update these requirements to recognise current practice and electronic health infrastrucure – RTPM for instance is a good way to address many of these issues.

      It’s also worth noting that e-scripts remove the need to retain repeats, so that’s one step in the right direction….

  2. Russell Smith

    PDL advice for other states, NOT NSW, please?

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