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Mulgrave Road Medical Centre
07 4044 0444

318 Mulgrave Road
Westcourt QLD 4870

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Narcotic, Sedative & Other Psychotropic Medications Policy

Practice Policy on the Safe Prescribing of Narcotic, Sedative, and other Psychotropic Medications

The Doctors Mulgrave Road Medical Centre’s Practice Policy on the ongoing use of Narcotic, Sedative and other Psychotropic medications is that; 

  1. It is unlawful for patients to consult a doctor and not reveal the quantities of controlled (Schedule 8) drugs they have received in the two months prior to the consultation. 
  1. It is illegal for doctors to prescribe controlled (S8) drugs, or restricted drugs of dependency (S4 drugs such as Tramadol, Panadeine Forte, Panadeine Extra, and benzodiazepines), to a person they reasonably believe to be drug dependent without the prior approval of the chief executive of Queensland Health. 
  1. As a matter of policy, this medical practice does not supply controlled substances (S8) drugs, or controlled substances of dependence including S4 medications such as Tramadol, Panadeine Forte, Panadeine Extra, Panadeine, or Benzodiazepines. 

Medical practitioners that overrule the medical practice’s policies must have a valid clinical reason to do so – and enter that reason into the medical records. 

  1. As a matter of policy, the medical practice does not supply medications that have been implicated in mixed-drug overdoses – such as Lyrica, Seroquel, Tramadol, narcotic or sedative drugs, Amitriptyline, or other psychotropic medications. 

Medical practitioners that overrule the medical practice’s policies must have a valid clinical reason to do so – and enter that reason into the medical records. 

  1. Prior to commencing the use of narcotic, sedative, and other psychotropic medications the prescribing doctor will check other relevant particulars by visiting Q Script online.

Prior to commencing the use of narcotic, sedative, or other psychotropic medications, the prescribing doctor at the The Doctors Mulgrave Road Medical Centre should discuss the particulars of the matter with the Prescription Shoppers Hotline. 

The Doctors Shoppers Hotline can be contacted on 1 800 631 131. 

The information available to the Doctors Shoppers Hotline (Prescription Shopping Information Service) can also be accessed online with a PRODA account. 

Prior to commencing the ongoing use of narcotic, sedative, or potentially harmful psychotropic medications, the prescribing doctor at the The Doctors Mulgrave Road Medical Centre should discuss the particulars of the matter with Queensland Health’s Monitored Medicines Unit. 

The Monitored Medicine Unit’s consultants can ordinarily only be contacted during normal business hours on 13 78 46 (13 S8 INFO). 

Discussing the situation with the Monitored Medicines Unit is a mandatory requirement of the initiation or continuation of a long-term narcotic or another S8 treatment program. 

  1. Two independent appropriately qualified and experienced registered medical practitioners should discuss, agree, and sign off on an appropriate short and long-acting treatment regime prior to initiating (or continuing another doctor’s treatment of) narcotic drugs for the treatment of non-cancer pain. 
  1. A doctor may, at their discretion, issue a prescription for a limited number e.g. seven (7) tablets of sedative or narcotic drugs for the treatment of non-cancer pain. 
  1. Prescribing doctors are reminded that; 
  • Because they act centrally, narcotic, sedative and other psychotropic medications are commonly associated with unwanted adverse side-effects, even whilst in the therapeutic range. 
  • The unwanted adverse side effects of narcotic, sedative, and other psychotropic medications include agitation, confusion, psychosis, impaired decision making, respiratory depression, accidental overdose, and death. 
  • Prescription medications that are commonly misused include narcotics, sedatives, Seroquel (Quetiapine), Gabalin, Pregabalin, and antidepressants, of which Amitriptyline is one. 

Please note the number of prescription medications implicated in accidental overdoses in an ever-expanding list. 

A list of the Prescription Shoppers Information Service targeted items can be found towards the end of the policy. 

Prescribing medical practitioners must ensure that the information they are acting upon is up to date. 

Medications can be toxic, or lethal when used in combination with alcohol, recreational drugs, illicit substances, and other prescription drugs. 

The presence of other agents may heighten the activity and toxic side effects, of narcotic, sedative, and other psychotropic medications – which may lead to an overdose of mixed medications, with potentially lethal side effects. 

  • When used in combination, narcotic, sedative, and other psychotropic medications can have particular toxic or lethal effects. 
  • There are a number of important mechanisms that medical practitioners can use to establish whether there is evidence that the patient has been prescribed other narcotic, sedative, or psychoactive medications – by us or alternate service providers. 

It is important to remember that, even when Q Script comes online, none of these mechanisms are guaranteed to be 100% effective, 100% of the time. 

Mechanisms available to doctors include; 

  • Q Script
  • Doctors Shoppers Hotline (1 800 631 181) 

The Doctors Shoppers Hotline (Prescription Shopping Program) operates a 24 Hour Service that can be rung or accessed online via a PRODA account. 

In the future, information from the Doctors Shoppers Program should be able to be accessed from our Best Practice Clinical Software. 

Prescription Shoppers may be identified by; 

  • The number of doctors they see, or; 
  • The number of targeted medications prescribed or dispensed. 

A list of the current targeted medications is supplied (towards the end of the policy). 

  • The Monitored Medicines Unit (13 S8 INFO – 13 78 46)

Queensland Health’s Monitored Medicines Unit keeps a record of;

  • Whether patients have or have not been on an opioid replacement program in Queensland, and; 
  • S8 Medications the patient has received in the past. 

 

  1. Prescribing doctors are reminded that patients seeking narcotic, sedative, or other psychotropic medication may present with genuinely distressing, and eminently believable stories – that do not accurately present the facts. Those may ultimately be found to be partially or completely untrue. 
  1. Prescribing doctors are also reminded that even with the best systems in place, patients may have alternate sources of recreational, illicit, and prescription drugs – for example, family, friends, or the general public at large. 

Prescription medications are commonly bought and sold. 

  1. Prescribing doctors should always; 
  • Check the validity of the underlying condition or conditions being treated; 
  • Make sure that the patient has an accepted clinical reason (according to current therapeutic guidelines) for narcotic, sedative, and other psychotropic drugs; 
  • Operate within safe limits; 
  • Ensure that their patients meet timely reviews. 
  • Refer the patient to ongoing allied health or specialist service providers, as required. 

The list of medicines currently being targeted by the Doctors Shoppers Hotline (Prescription Shopping Information Service) in generic terms, not trade names, includes;

 Acamprosate

Alprazolam

Amitriptyline

Asenapine

Atomoxetine

Bromazepam

Buprenorphine

Buprenorphine + Naloxone

Bupropion

Citalopram

Clonazepam

Clozapine

Codeine

Desvenlafaxine

Dexamphetamine

Diazepam

Dothiepin

Doxepin

Duloxetine

Escitalopram

Fentanyl

Flunitrazepam

Fluoxetine

Fluvoxamine

Gabapentin

Hydromorphone

Lisdexamfetamine

Lithium carbonate

Methadone

Methylphenidate

Mianserin

Midazolam

Mirtazapine

Modafinil

Morphine

Naltrexone

Nicotine

Nitrazepam

Olanzapine

Oxazepam

Oxycodone

Oxycodone + Naloxone

Paracetamol + Codeine

Paroxetine

Phenobarbitone

Pregabalin

Quetiapine

Reboxetine

Sertraline

Tapentadol

Temazepam

Tramadol

Varenicline

Venlafaxine

Zopiclone

Suggestions regarding the manner by which the The Doctors Mulgrave Road Medical Centre’s Narcotic, Sedative and other Psychotropic Medication Policy can be forwarded to:

 

Dr Evan Nicholls

Medical Director and Program Manager

Cairns 24 Hour Medical Centre, Townsville GP Superclinic, The Doctors Mulgrave Road Medical Centre, Nicholl Holdings Pty Ltd

admin@mulgraveroad.com.au