PBS puts prescribing restrictions on opioids for non-chronic pain


By Michael Woodhead

3 Jun 2020

Revised PBS listings from 1 June will cut the amounts of opioid medication that can be prescribed and ban repeat prescriptions for treatment of non-chronic pain.

The changes, introduced as part of measures to tackle increasing pharmaceutical opioid misuse and deaths in Australia will reduce the quantities of immediate-release opioids available on prescription for acute pain, for example by limiting packs to 10 tablets rather than 20 tablets.

In addition, new Restricted Benefit listings will not allow increased quantities or repeats of opioids for patients requiring short-term relief of acute severe pain.

The changes apply to opioids such as tramadol and paracetamol-codeine combinations as well as more potent opioids including oxycodone.

There will also be new restrictions for patients starting on high-strength opioids for chronic pain, such as morphine and fentanyl.  To be eligible for treatment, patients will need to be unresponsive or intolerant, or have achieved inadequate relief of their acute pain, following maximum tolerated doses of other lower strength opioid treatments.

The PBS says that patients who require long-term treatment of chronic pain with opioids will still be able to access larger pack sizes and prescribers will be able to prescribe repeats where they meet the new restrictions requirements.

Increased quantities to extend treatment up to one month may be requested via telephone/electronic authority request, and up to 3 months’ supply (up to 1-month quantity and up to 2 repeats) may be requested via an electronic/written authority request.

In other changes to take effect from 1 June, modified release paracetamol products are upscheduled to make the pharmacist only (S3), meaning they will be kept behind the counter.

The restriction of paracetamol products containing 665mg compared to 500mg in the immediate release products, is intended to reduce the potential for inadvertent overdosing.

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