The AMA has released a submission to the TGA on the proposed enhanced regulation of Schedule 8 opioids, saying a regulatory approach should a “last resort” used only after alternative, non-legislative approaches were proven to be ineffective.
The option of removing the highest dose opioid products from the market or restricting them to specialist prescribing would prevent patients who needed higher doses from accessing these medicines and appeared to be an “excessive” response, the AMA said.
“Preventing general practitioners from prescribing these medicines would pose considerable hardship in situations where patients live in rural/remote areas or have other difficulties accessing specialist doctors, palliative care and/or pain clinics,” the AMA said.
Instead, restrictions already in place in some states and territories which required GPs to apply for annual approval and/or specialist approval or support before prescribing above certain doses, appeared to be working well and provided clear support and guidance for doctors and patients.
The AMA said it would support any Department of Health moves to implement a consistent national approach to these restrictions.
There was also considerable scope to “enhance and implement” educational activities, including using PBS and Medicare data to identify practitioners prescribing S8 opioids in a different manner to the majority of their peers and issuing advisory letters to influence prescribing behaviour.
The association also said it supported proposals on making smaller pack sizes available for treating patients with acute pain, as well as larger pack sizes for those with cancer-related chronic pain.