In the wake of recent changes to the availability of pain medicines, many in our networks have asked what medicine scheduling means and how it affects them.
If you are walking down the street and stopped by police, you’d certainly rather have just picked up a schedule 2 substance than a schedule 9. If you are feeling ill and need relief, your GP may prescribe you a schedule 4 medicine. What does this all mean? Let me explain.
Scheduling is a national classification system that controls how medicines and poisons are made available to the public. Medicines and poisons are classified into schedules according to the level of regulatory control over the availability of the medicine or poison, all with the aim of protecting public health and safety.
When looking at the scheduling of a medicine, what is considered is the safety of the medicine; it’s effects; and the risks of misuse and dependency, just to name a few.
Here are three examples of how schedules may have affected you and below that is a rundown of what the schedules are.
Codeine – sold as Nurofen Plus, Panadeine Forte, Mersyndol and Codral – which has remained available over-the-counter in Australia despite access to the drug requiring a prescription in 26 countries around the world until February 2018 when it was rescheduled by the Therapeutic Goods Administration (TGA) meaning access to the drug now requires a prescription.
Opioids – On 1 June 2020, changes were made to many opioids and multiple formulations listed on the PBS General Schedule (Section 85). The changes included new listings for half pack sizes, increased restrictions for full pack sizes, and new and amended clinical criteria, prescriber instructions and administrative advice.
Paracetamol – Supermarkets able to sell packets of only 20 tablets or less, while packets of more than 20 tablets can be sold only in pharmacies.
Not currently in use
Pharmacy medicine – Medicines that are available on the shelf at pharmacies.
Pharmacist only medicine – Medicines that are available from a pharmacist
without a prescription. These medicines are usually behind the pharmacy counter.
Prescription only medicine – Medicines which must be prescribed by an authorised healthcare professional (such as your doctor). They may be supplied in hospital or bought from a pharmacy with a prescription.
Caution – Chemicals which are not likely to cause harm. They need suitable packaging with simple warnings and safety directions on the label.
Poison – Chemicals with a moderate risk of causing harm. They need special packaging with a strong warning and safety directions on the label.
Dangerous poison – Chemicals with a high risk of causing harm in low doses. They are only available to certain people who are able to handle them safely. There may be special rules for selling, using or storing these chemicals.
Controlled drug – Medicines or chemicals which have special rules for producing, supplying, distributing, owning and using them. These medicines may only be prescribed by an authorised healthcare professional who may need a special prescribing permit.
Prohibited substance – Chemicals which may be abused or misused. They are illegal to produce, own, sell or use except if needed for medical or scientific research.
Chemicals that are so dangerous they are banned altogether. These substances are of such danger to health as to warrant prohibition of sale, supply and use.
The schedules are published and given legal effect through State and Territory legislation through the Poisons Standard, which is also referred to as the Standard for the Uniform Scheduling of Medicines and Poisons. This means that each State and Territory is responsible for how it applies the schedules. In some cases, the packet size (as it was with the opioid changes) may determine where and how the medicine can be sold.
So hopefully reading this, the next time it is recommended you take a schedule 3 medicine or are prescribed a schedule 4 medicine you will be better informed about what it is.