Home > Prescribing drugs of dependence in general practice, Part A – Clinical governance framework.

The Royal Australian College of General Practitioners. (2015) Prescribing drugs of dependence in general practice, Part A – Clinical governance framework. Melbourne: The Royal Australian College of General Practitioners.

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This guide on clinical governance is a starting place for general practice to be a solution to problematic prescription drug use. The guide is a living document and will be regularly updated.

Summary of Recommendations

1. Introduction




1.1 Aims

1.2 How to use this guide

1.3 Why do we need this guide?

1.4 Developing an environment for quality improvement in prescribing of drugs of dependence


2 Laws and regulations

2.1 Legislative requirements

2.2 Regulatory, professional bodies and monitoring bodies


3. General practice systems of care

3.1 The medical home model of care

3.2 Practice accreditation

3.3 Clinical leaders

3.4 Staff education and competency

3.5 Balancing patients’ needs with practice capacity (risk stratification)

3.6 Coordination of care

3.7 Practice policies

3.8 Using information – Government resources

3.9 Quality improvement activities


4. Accountable prescribing

4.1 Being an accountable prescriber of drugs of dependence

4.2 Assessment of patient risk

4.3 Providing patients with other (often better) management options


5. Patient Focus

5.1 Shared decision making


A. Key terms and definitions

A.1 Drugs of addiction and drugs of dependence

A.2 Tolerance, dependence, substance use disorder and withdrawal

A.3 Misuse, non-medical use and abuse

A.4 Drug-seeking behaviour

A.5 Prescriber behaviour

B. Drug scheduling

B.1 Drug schedule

B.2 S8 terminology variations across Australia

C. State and territory legislation and contacts

C.1 Non drug-dependent persons – Legislative requirements when prescribing S8 drugs

C.2 State/territory contacts

D. Example practice policies

D.1 Practice policy – Opioid prescribing policy for patients

D.2 Practice policy – Restriction of prescribing rights for drugs of dependence

D.3 Practice policy – Handover standards

D.4 Practice policy – Continuation of opioid management plans for new patients originating from external healthcare providers

D.5 Practice policy – Drugs of dependence therapy agreement

D.6 Practice policy – Requests for repeat scripts for drugs of dependence

D.7 Practice policy – Risk assessment for patients with complex needs

D.8 Practice policy – Approach to drug seeking patients

D.9 Practice policy – Opioid dosing thresholds

D.10 Practice policy – One-year review of opioid prescribing

D.11 Practice policy – Opioid reduction policy

D.12 Practice policy – Benzodiazepine fact sheet for patients

D.13 Practice policy – Opioid fact sheet for patients

D.14 Practice policy – Simple checklist for a general practice to examine its quality management of drugs of dependence


Practice letters

Drug misuse behaviours

Assessment of current drug and alcohol use

Urine drug testing


I.1 Staff safety

I.2 Risk assessment

I.3 24-hour drug and alcohol services

Process of guide development

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