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Schedule 8 and Pharmacotherapy online permit application forms are no longer available on this website. Applying for a permit in SafeScript is quicker and easier as SafeScript will pre-fill much of the required information for you. If you experience any technical issues with SafeScript, please contact SafeScript technical support for assistance on or it. Alternatively, you can download a PDF of the application form and send your completed application by email or fax. The Department of Health helps to protect the community from the potential harm of medicines and chemicals. One way it does this is through controls defined in Victorian Drugs, Poisons and Controlled Substances legislation. This legislation is applicable to substances that are listed in the Australian Standard for the Uniform Scheduling of Medicines and Poisons. Victorian legislative controls for these substances vary according to their risk. Some of these controls include:. For a full list of online forms, please visit the Online Forms - Medicines and Poisons Regulation web page. If you have issues registering with SafeScript or logging in SafeScript, please contact SafeScript technical support on The Australian Government has announced its intention to take strong action to address vaping in Australia, by introducing a comprehensive range of reforms. Legislative requirements and process for obtaining S9 permits in human clinical trials. Legislative requirements for medical practitioners and nurse practitioners wishing to obtain permits to prescribe Schedule 8 medicines and warrants to prescribe selected Schedule 4 poisons. Apply for, or change a licence or permit to possess and possibly supply scheduled substances. Latest updates in the medicine and poisons sector including changes to regulatory requirements, authorisations, emergency supply and monitoring of specific items. Includes medications in aged care, poisons code, approvals by Minister and Secretary, synthetic cannabinoids and e-cigarettes. Opioid replacement therapy. Legislative requirements and policies associated with the use of methadone and buprenorphine in the provision of opioid-replacement therapy. Summaries of legislative requirements and related forms for different health practitioners. Legislative requirements for medical practitioners, nurses, midwives, pharmacists, veterinary practitioners, dental practitioners, optometrists and podiatrists. Medicines and Poisons Regulation Department of Health. Skip to main content. Medicines and Poisons Regulation. Apply for Schedule 8 and Pharmacotherapy permits in SafeScript Schedule 8 and Pharmacotherapy online permit application forms are no longer available on this website. Application for a permit to treat patient with Schedule 8 drugs pdf Application for a permit to treat an opioid-dependent person with methadone or buprenorphine pdf E-cigarettes and vaping The Australian Government has announced its intention to take strong action to address vaping in Australia, by introducing a comprehensive range of reforms. Schedule 9 permits for clinical trials Legislative requirements and process for obtaining S9 permits in human clinical trials. Patient Schedule 8 treatment permits Legislative requirements for medical practitioners and nurse practitioners wishing to obtain permits to prescribe Schedule 8 medicines and warrants to prescribe selected Schedule 4 poisons. Licences and permits to possess and possibly supply scheduled substances Apply for, or change a licence or permit to possess and possibly supply scheduled substances. Medicines and poisons recent updates Latest updates in the medicine and poisons sector including changes to regulatory requirements, authorisations, emergency supply and monitoring of specific items. Frequently Asked Questions — Medicines and Poisons Regulation This page contains answers to the most frequently asked questions. Legislation and approvals Includes medications in aged care, poisons code, approvals by Minister and Secretary, synthetic cannabinoids and e-cigarettes. Pharmacotherapy opioid replacement therapy Opioid replacement therapy. Documents and forms to print or download — medicines and poisons regulation Summaries of legislative requirements and related forms for different health practitioners. Health practitioners Legislative requirements for medical practitioners, nurses, midwives, pharmacists, veterinary practitioners, dental practitioners, optometrists and podiatrists. In this section. New Schedule 8 permit requirements from 28 March The Schedule 8 permit requirements for patients who are not drug-dependent will resume on 28 March following the expiry of the Schedule 8 permit Public Health Emergency Order on 27 March More information. Subscribe to our alerts, advisories and newsletters. Send a query. Share this page Facebook , opens a new window X formerly Twitter , opens a new window LinkedIn , opens a new window. Was this page helpful? Yes No. Tell me your email for content rating.

Kicking the Habit: The Opioid Crisis and America’s Addiction to Prohibition

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The federal government has responded predictably, criminally prosecuting doctors who prescribe opioids to the drug dependent. The approach may seem sensible, but it is as wrongheaded as our century-old drug war. For individuals addicted to opioids or suffering from chronic pain, a war on drugs has never been a prescription for improving wellness. This dominant abstinence-based policy model is grounded in the logic of prohibition, and it depends not upon healing but upon shame, isolation, prosecution, and penalty. International and historical public health efforts have demonstrated that one of the best ways to confront epidemic drug use is addiction maintenance—that is, establishing medically supervised clinics to provide pharmaceutical-grade narcotics often free of charge in amounts calibrated to maintain the social and physical well-being of the drug dependent. In this policy analysis, we survey these international and historical efforts. We look to our own past to examine the roots of the modern American drug war and describe contemporary reforms both within and beyond the opioid crisis. We explain how meaningful change is likeliest to occur: from the ground up, as a product of underground experimentation initiated by and within the most-affected communities. Finally, we offer our own public health prescription: a set of pragmatic harm-reduction responses to prohibition and its counterproductive and often deadly effects. For a century, the United States has fought a war on drugs. The state has diverted manpower from opium to other substances, including heroin, marijuana, hallucinogens, powder and crack cocaine, and prescription and nonprescription opioids. Likewise, police, prosecutors, and politicians have supplemented conventional statutory approaches, such as the Harrison Narcotics Act, with more powerful policies, including the Controlled Substances Act and other state-law corollaries. For instance, law enforcement has kept its sights trained throughout the drug war on low-income and minority neighborhoods. More to the point, the goal of the drug war— punitive prohibition —has never shifted. With the exceptions of alcohol, tobacco, and, to a narrow extent, marijuana, recreational drugs are still forbidden, and users are still prosecuted. The state has consistently prohibited much more, even prosecuting the activists and medical professionals who would help problematic drug users through unconventional but promising means. It has defunded studies searching for innovative approaches to solve the problems arising from drug use and abuse, and it has undermined local reform efforts. It is enough, however, to flag three principal influences. Third, and more subtle, the logic of punitive prohibition follows a fixation with rules. Prohibition is what happens when public policy is left to be shaped from the top down. The war on drugs exposes a particular drawback of law, legal institutions, and the legal turn of mind: all have a tendency toward rigid rules, intimidation, and aversion to risk and experimentation. While some legal regimes and bureaucratic frameworks have great value, many tend to fall prey to limited perspectives that not only make for misguided public policy but also complicate course correction. Simple answers are preferred to the pursuit of nuanced solutions. But those three words succinctly describe much more: a century of a state-sponsored war on drugs that has proven to be a public health failure. Yet now, in the face of a brutal opioid crisis, there is a modicum of energy for genuine drug policy reform—for a shift from the prevailing just-say-no mentality. The shift is welcome, of course. Still, it is hard to get too excited about a newfound enthusiasm that is, in itself, seemingly grounded in racial bias. White America has opened its eyes to the evils of the drug war at the very moment that the opioid epidemic has begun to plague rural and predominantly white communities. We would rather see reform grounded in a genuine commitment to civil, constitutional, and human rights—in a commitment to the liberty, equality, dignity, and interests of all drug users and their circles of social support. All the same, we are pragmatic drug policy reformers. In this policy analysis, we address the historical and contemporary approaches to addiction treatment and policy. First, we recall a time, before our centurylong war on drugs, when America responded to an opioid epidemic not with prohibition but with an intervention known as addiction maintenance—that is, providing drugs in amounts calibrated to maintain the well-being of dependent persons. We examine what changed and how we came to abandon that harm-reduction model. In the process, we explore some of the advantages of addiction maintenance in its modern form. Then we discuss how, when, and why addiction maintenance works and evaluate what stands in the way of addiction maintenance. Finally, we survey a host of domestic reform efforts and provide a framework for understanding when, how, and to what extent these endeavors have succeeded. As these reform efforts reveal, addiction maintenance is only one front in harm reduction. Indeed, additional reforms necessarily must precede addiction maintenance because the practice is appropriate only after the failure of other much-needed therapeutic interventions—such as medication-assisted treatment with methadone, buprenorphine, or suboxone, none of which are uniformly available at present. We conclude with a six-point plan, designed to address the current opioid crisis in a manner that moves away from prohibition and toward harm reduction. Throughout the 19th century, drugs remained mostly unregulated. Before the ban, almost all opiate users would buy a mild form of the drug at their corner store for a small price. But virtually none of them committed crimes to get their drug, or became wildly out of control, or lost their jobs. Then the legal routes to the drug were cut off—and all the problems we associate with drug addiction began: criminality, prostitution, violence. Medical professionals of the era considered opioid abuse a public health problem. By the turn of the century, the push for prohibition had begun—in part as a means to control minority communities. Politicians, pastors, and the press drew specious links between drug abuse and the exploitation of white women. Then, as now, whites used drugs at rates comparable to—and perhaps even higher than—other populations. Unsurprisingly, then, the first shots of the drug war were, like most shots since, targeted strikes against poorer and darker communities. What did early regulation look like? In , Congress passed the Harrison Narcotics Tax Act, which taxed, but did not wholly prohibit, the production and distribution of cocaine and opioids. Health officials not only treated but also tracked patients. It seems that the efforts were largely successful. If nothing else, they initially enjoyed widespread support from city councils, boards of health, and even local law enforcement. First, in Webb v. United States , the court endorsed a different approach:. But Linder would prove to be sui generis—an exception to the dominant rule, applied to a case where the doctor had prescribed only a relatively small dose. And, with the passage of the Eighteenth Amendment, the logic of prohibition became a constitutional mandate, shifting both legal and cultural norms. With the repeal of the Eighteenth Amendment in , there was, perhaps, some hope that the state might soften its approach to prohibition writ large. The government had its reasons, of course, to worry about unscrupulous physicians who indiscriminately dispensed opioids and other drugs. Beyond our borders, several cities and countries have, for some time, successfully provided free, uncontaminated, comparatively safe narcotics to persons addicted to controlled substances. The results were transformative. To date, Insite claims to have reversed nearly 5, overdoses without suffering a single overdose death. But, ultimately, the safe site was not enough to effectively serve the needs of drug-affected Vancouver communities. Thus the city opened the Providence Crosstown Clinic, which operates on a genuine addiction maintenance model. The aim is palliative care. Likewise, Switzerland opened addiction maintenance clinics in the s. Portugal has implemented even more ambitious harm reduction measures and has achieved even greater success. Portuguese rates of drug use remain relatively high, but rates of hard drug use have declined, with heroin use declining by an astounding two-thirds from its peak. Why have these international efforts proved so successful? First, they are finely targeted to the challenges facing dependent drug users and are designed deliberately to help those users at critical moments. Heroin and other opioids are prescribed only after the failure of other efforts—whether therapeutic interventions or criminal enforcement. The goal of addiction maintenance is harm reduction—a reduction in the harms that flow from illicit drug markets, infectious diseases, overdoses, and criminal enforcement and punishment. And, even though addiction maintenance is intended only to provide palliative care, there is some evidence that—under the right circumstances—it may reduce overall drug use. How could it be that free access to opioids might help dependent users get clean? Appreciate, first, the context in which drugs are most often abused. The environmental theory of addiction insists that pharmacology is only secondarily related to dependence. This is the environmental theory of addiction; consider a series of animal studies. The second set enjoyed meaningful lives, and those rats had less desire or compulsion to fill the void with self-harm. Now consider the life of a drug user under the framework of prohibition. The threat of criminal repercussions drives users underground in search of drugs of unknown quality and provenance while isolating them from the resources and support systems needed to address addiction. The more you de-stress people, the less they are going to use. So to create a system where you ostracize and marginalize and criminalize people, and force them to live in poverty with disease, you are basically guaranteeing they will stay at it. When these international municipalities and governments abandoned prohibition and focused instead on eliminating barriers to drug acquisition, drug users were better able to focus on self-improvement. Their ties to family, community, education, and employment were strengthened or at least left intact. The conclusion is inescapable. Addiction need not be a terminal condition. And, for the most dependent, the most promising treatment may just be to feed the habit. This is what addiction maintenance programs are designed to achieve. They try to keep the hopeless addict alive, relatively healthy, and socially integrated long enough to navigate, eventually, to the other side of the age divide—to steer clear of the most destructive and deadly byproducts of punitive prohibition. Drug manufacturers pushed opioids on doctors. The short answer is that recent American experience cannot be understood as addiction maintenance. Under addiction maintenance, people who abuse opioids and who have failed to respond to other kinds of treatment, including methadone maintenance, would be admitted into medically supervised clinics and provided pharmaceutical-grade narcotics in amounts calibrated to reduce the harms of obtaining and using drugs from illicit markets while maintaining social and physical well-being. Our prevailing licensing regime permits doctors to prescribe opioids only until patients become dependent. Use-reduction logic might seem simple enough: fewer prescriptions for pills should correspond with less use by the drug dependent. And, indeed, prescription opioid use has dropped dramatically in recent years. Patients become criminal buyers, the price of heroin undercuts illicitly diverted pharmaceuticals, syringes replace pills, and dealers cut drugs with fentanyl and other dangerous chemicals. According to Johann Hari:. She is allowed to prescribe to treat only my physical pain—not my addiction. Most of the problems attributed to prescription drugs in the United States … begin here, when the legal, regulated route to the drug is terminated. As opioid prescriptions have plummeted, opioid-linked deaths have skyrocketed. One dealer may find it profitable to dilute a batch and sell more. Another dealer may cut costs by adding cheap fentanyl—an extremely potent and highly lethal synthetic opioid for which even seasoned opioid users may lack tolerance. More to the point, dealers may not even be aware of the purity and potency of their own unlabeled and unregulated goods. And comparatively milder prescription drugs, which were previously more accessible on pharmacy shelves, are often just too expensive and bulky for street-level sellers to keep in stock. Recent reform efforts have made the problem only worse. The current war on opioids is, like the first war on drugs, a war on physicians. The escalation and crackdown are not unique to federal law enforcement. In turn, physicians have stopped treating patients whose health could genuinely benefit from large or long-term doses of prescription opioids. This is overdeterrence in action—another example of how prohibition chills socially valuable conduct at the margins. Moreover, they are likelier to be aware of and comply with the heightened recordkeeping requirements that law enforcement may use to trawl for patient and physician targets. There is too much risk involved. Meaningful domestic drug reform has only ever arisen from the bottom up. Take the example of syringe exchanges. The DEA, for example, had previously promulgated the Model Drug Paraphernalia Act, which provided a template for 46 states to criminalize the manufacture, possession, or distribution of drug paraphernalia, broadly defined. Consider the example of medical cannabis. Today, a majority of states permit at least some form of medical use. Nevertheless, the federal government remained largely intransigent. In , after California voters passed the Compassionate Use Act by proposition, federal authorities threatened physicians with civil and criminal penalties merely for recommending medical cannabis. In spite of these hurdles, activists found a way to build a grassroots movement around medical cannabis, establishing a collection of underground dispensaries. To these examples, we could add the drug-court movement, which now boasts over 2, courts currently operating nationwide. The movement operates within criminal justice, retaining the threat of punishment as a backstop for the noncompliant participant. Disappointingly, but perhaps unsurprisingly, many leading drug-court advocates have tended, therefore, to publicly oppose more ambitious drug policy reform, including the decriminalization of cannabis even for medical use , reduction of felony possession offenses to misdemeanor or noncriminal offenses, and acceptance of and reliance upon medication-assisted treatments. The origins of the drug-court movement can be traced to a small handful of ground-level advocates in this case, county judges and local law enforcement who could no longer countenance the most egregious excesses of the drug war, such as lengthy jail and prison sentences for low-level, nonviolent drug offenders. These examples illustrate the failure of the drug war and the role of grassroots activism in driving meaningful change. Although there has been some progress, such issues remain with respect to the opioid epidemic. Until relatively recently, federal and state laws largely prevented most people from preemptively gaining access to naloxone, an opioid antagonist, which reverses overdoses. Technically, some physicians could still prescribe naloxone, but any such efforts were resisted by public officials, law enforcement, and even many within the medical community. To withhold it is to endorse the view that death is an appropriate punishment for those who overdose. Enter the street activists. Piggybacking on the highly successful work of a syringe exchange program in Chicago, activists began distributing naloxone to syringe-exchange clients and taught them how to administer naloxone to reverse an overdose. In short order, communities across the country began to distribute or turn a blind eye to the distribution of naloxone; municipal and state-level law and policy reform followed thereafter. By July , all 50 states and the District of Columbia had taken legal steps to increase access to naloxone. Four dynamics describe these drug policy reforms. First, until harm reduction interventions are well established, public officials and law enforcement agents are typically part of the problem, not the solution. Policymakers and professionals initially either opposed pragmatic harm reduction measures or stayed mum, fearing backlash. Criminal justice has its jail and prison cells, paid prosecutors and judges, and police, probation, and corrections officers. The prescription drug industry has its drug representatives, scientific researchers, public relations professionals, and political lobbyists. Organized drug crime has its guns and safe houses, gang members, foot soldiers, and street dealers. The pressure is tremendous to keep feeding the drug-war machinery. No surprise, then, that institutional elites tend to make bad insurgents. Second, and relatedly, public health innovations typically start underground. For years—without any change in local, state, or federal law—sterile syringes were exchanged, medical marijuana was ingested, and naloxone was distributed and injected. Third, if and when de jure reform occurs, it often bubbles up from below. Fourth, all the while, the federal structure stays largely intact. Its orientation remains prohibition first. At best, federal officials may tolerate local experimentation. But the federal law remains criminal law—the Controlled Substances Act and other punitive statutes like it. Even today, federal support for syringe exchanges is largely passive. Likewise, the federal government continues to oppose medical cannabis. And, perhaps more importantly, it continues to stifle medical-cannabis research, thereby keeping technically true the hollow claim that the substance has no proven medical benefits. It is against this backdrop—and within this framework—that we should consider addiction maintenance. Addiction maintenance is more than a theoretical possibility; it is a historical and international reality. But, as a domestic practice, it remains a distant prospect. How distant is unclear. By nature, underground enterprises are hard to track. It could well be that an American addiction maintenance clinic is operating illegally already—either with a wink and nod from local officials or completely underground. The lives of heroin-dependent persons rely upon access to pharmaceutical-grade heroin instead of toxic street-corner junk. More to the point, a precursor to the addiction maintenance clinic has already begun to find traction—the safe site, or supervised injection facility, which does not supply drugs but provides a space for relatively safe consumption. That is what happened with syringe exchanges and medical cannabis. More to the point, that is what happened in Vancouver where underground efforts by street activists eventually produced a legally authorized supervised injection facility. The drug-free society is a pipe dream. If, instead, we were to acknowledge that drugs are an often but not always unfortunate fact of life, we might come to regard drug misuse, abuse, dependence, and addiction for what they are—questions of health, not morality, and of social policy, not penology. Our success would not be measured by our proximity to a drug-free America but whether we have minimized drug-related deaths, disease, crime, and suffering, whether we have improved health and welfare, and whether we have preserved and expanded autonomy and dignity. We remain doubtful that American society and its legal and medical institutions can reorient wholly from a criminal-legal model to a public health model. The logic of prohibition has enjoyed too much dominance for far too long. Few medical schools meaningfully incorporate addiction treatment into core curricula, and few new doctors choose to specialize in addiction medicine. Moreover, until relatively recently, insurance providers could legally refuse to cover addiction treatment—at least, more readily than other accepted medical interventions. Although many medical professionals have been on the front lines of the most ambitious drug policy reforms, it is still not uncommon to encounter doctors who harbor the same attitudes as prohibitionists. However, precisely because culture plays such an influential role in drug policy and medical practice, there is a silver lining to the immediate epidemic. The opioid crisis has awoken a previously indifferent America to the failings of prohibition. We are especially encouraged—and somewhat surprised—that the Senate, by a remarkable vote of 99 to 1, recently passed sweeping legislation that could make it easier for doctors to prescribe suboxone buprenorphine and other forms of medication-assisted treatment for addiction. All in all, we expect to see mainly street-level activism and politically popular local initiatives but too few positive steps beyond that. The logic of prohibition will continue to predominate, and the machinery of criminal punishment will continue to churn. The empirical and anecdotal evidence is persuasive that these interventions will save lives, alleviate suffering, and lessen drug-related crime. Criminal law is the wrong tool for addressing the opioid epidemic. People are dying in record numbers, and we must acknowledge and abandon our addiction to punishment and broaden our legal horizons to adopt measures proven to reduce and avoid harms related to both drug use and enforcement of the drug war. Bowers, Josh, and Daniel Abrahamson. Put simply, legal training facilitates incuriosity by emphasizing hierarchical and rule-bound thinking. Derrick A. Bell Jr. By way of explanation, harm-reduction models focus on minimizing the negative social, economic, and physical externalities that flow from human behaviors. Robert J. By way of analogy, imagine two methods for promoting sexual health—providing free condoms or criminalizing contraceptives. Harm reduction describes the first approach; prohibition describes the second. Alfred R. Alexander Cockburn and Jeffrey St. Clair, Whiteout , p. Cockburn and St. Ellen M. David T. William J. Harrison Narcotics Tax Act of , Pub. Musto, American Disease , pp. Thomas M. Quinn and Gerald T. Jin Fuey Moy v. United States , U. Webb v. United States v. Behrman , U. New York: W. Norton, , p. Linder v. Khary K. Rigg, Steven P. Kurtz, and Hilary L. Baltimore: Abell Foundation, January Hari, Chasing the Scream , p. Hari, Chasing the Scream , pp. Canada Attorney General v. Evan Wood et al. Kreit, Controlled Substances ; and Cockburn and St. Luis M. Thomas Lathrop Stedman, ed. Boston: Houghton Mifflin Company, September Philip B. Heymann and William N. Why Is This Widely Denied? Department of Justice. By way of further example, the state of Missouri announced that it plans to crack down on 8, doctors for overprescribing opioids. Joy, Stanley J. Watson Jr. Benson Jr. Forest Tennant Retiring. Don C. Consolidated Appropriations Act, Pub. New Mexico Stat. Bakalar, Marihuana: The Forbidden Medicine , rev. Joy, Marijuana and Medicine , p. Conant v. Walters , F. Drug Enforcement Administration , 15 F. Randall and Alice M. As both authors have examined elsewhere, court-imposed treatment depends upon a logical and normative flaw: the more typical drug-court graduate is the least compulsive user; the genuinely addicted drug user, by comparison, is likelier to fail out and face a draconian termination sentence—a jail or prison sentence longer, perhaps, than even traditional drug penalties. Daniel N. Michael C. Dorf and Charles F. Corey S. Leo Beletsky et al. Grinspoon, The Forbidden Medicine , pp. Bluthenthal, Alex H. Kral, Jennifer Lorvick, and John K. Chriqui, Rachel M. Safehouse , Civil Action No. October 2, For instance, officials in Ithaca, New York, are likewise considering the reform. Lisa W. Clair, Whiteout , and accompanying text. Matthew R. Tibor M. Brunt et al. Live Now. Policy Analysis. Early Addiction Maintenance Efforts. International Public Health Efforts. Legal Roadblocks. The Future of Reform. About the Authors. Josh Bowers is the F. Show Endnotes. Hide Endnotes. Notes Many thanks to Rebecca Rubin for her exceptional research assistance. Clair, Whiteout. Hari, Chasing the Scream. Davis, Legal Interventions. Kicking the Habit.

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