Standard for the Uniform Scheduling of Medicines and Poisons
The Standard for the Uniform Scheduling of Medicines and Poisons, also known as the Poisons Standard for short, is an Australian legislative instrument produced by the Therapeutic Goods Administration. Before 2010, it was known as the Standard for the Uniform Scheduling of Drugs and Poisons. The SUSMP classifies drugs and poisons into different Schedules signifying the degree of control recommended to be exercised over their availability to the public.
The Schedules are referred to under State and Territory legislation for regulatory purposes. Although each State and Territory has its own laws, the vast majority of medicines and poisons are classified according to the SUSMP to achieve uniform national regulation.
Schedules
Schedule 1
Schedule 1 is blank. Schedule 1 does not currently contain any medicines or poisons.Schedule 2: Pharmacy Medicine
Schedule 2 drugs and poisons, otherwise known as Pharmacy Medicines, are substances and preparations for therapeutic use that –- are substantially safe in use but where advice or counselling is available if necessary;
- are for minor ailments or symptoms that –
- * can be easily recognised by the consumer and
- * do not require medical diagnosis or management.
- Dextromethorphan, a cough suppressant
- Simple analgesics such as aspirin, paracetamol, ibuprofen and naproxen in packs containing more than 24 tablets
- Hyoscine, used to treat motion sickness, postoperative nausea and vomiting.
- Nonsedating antihistamines such as loratadine
- Nasal sprays containing decongestants or steroids
The location of these medications in the pharmacy varies from state to state.
Schedule 3: Pharmacist Only Medicine
Schedule 3 drugs and poisons, otherwise known as Pharmacist Only Medicines, are substances and preparations for therapeutic use that –- are substantially safe in use but require professional advice or counselling by a pharmacist;
- require pharmacist advice, management, or monitoring;
- are for ailments or symptoms that –
- * can be identified by the consumer and verified by a pharmacist;
- * do not require medical diagnosis, or only require initial medical diagnosis, and do not require close medical management.
Examples:
- Orlistat
- Pseudoephedrine
- Salbutamol
- Rikodeine
Schedule 4: Prescription Only Medicine
- require professional medical, dental, or veterinary management or monitoring;
- are for ailments or symptoms that require professional medical, dental, or veterinary diagnosis or management;
- may require further evaluation for safety or efficacy;
- are new therapeutic substances.
- cost of the drug is high, or when there is a risk of dependence
Examples:
- Amoxicillin
- Anabolic steroids
- Apomorphine
- Cannabidiol in preparations for therapeutic use containing 2 percent or less of other cannabinoids found in cannabis
- Cisplatin
- Co-codamol preparations comprising codeine and paracetamol
- Ephedrine
- Ergotamine
- Estradiol
- Fluticasone
- Ibogaine
- Isotretinoin
- Methoxyflurane
- Pseudoephedrine in large doses
- Salmeterol
- Tramadol
- Tretinoin
- Trimethoprim
- All benzodiazepines except flunitrazepam and alprazolam
- All:
- *SSRIs,
- *SNRIs,
- *TCAs
- *MAOIs.
- Antipsychotic drugs
Schedule 5: Caution
- have low toxicity or a low concentration;
- have a low to moderate hazard;
- can cause only minor adverse effects to the human being in normal use;
- require caution in handling, storage, or use.
- Ammonia
- Acetic acid
- Boric acid
- Chlorinating compounds
- Clove oil
- Ivermectin
- Lidocaine
- Methylated Spirits
- Petrol
Schedule 6: Poison
Must use distinctive packaging and strong warnings to display the potential for:- moderate to high toxicity;
- that may cause death or severe injury if ingested, inhaled, or in contact with the skin or eyes.
Some of the above examples are subject to exceptions dependant on the specific preparation, concentration, or inclusion in other schedules.
Schedule 7: Dangerous Poison
Substances with a high potential for causing harm at low exposure and which:- Require special precautions for manufacture, handling or use; or
- Only available to specialised and authorised users with appropriate skills
- Special regulations regarding their availability, possession, storage or use may apply
Some of the above examples are subject to exceptions dependant on the specific preparation, concentration, or inclusion in other schedules.
Schedule 8: Controlled Drug
Schedule 8 drugs and poisons, otherwise known as Controlled Drugs, are schedule 9 prohibited substances that are appropriate preparations for therapeutic use which have high potential for abuse and addiction. The possession of these medications without authority is the same as carrying a prohibited substance and is illegal.Like schedule 4 substances, the price of many Schedule substances are subsidized through the Pharmaceutical Benefits Scheme, some of which may require an authority. In addition, in some states, all drugs on schedule 8 require a doctor to have an S8 permit before prescribing treatment. For example, in NSW the prescribing of Schedule 8 CNS stimulant medication requires authorisation from the NSW Ministry of Health and is generally restricted to specialists, such as paediatricians and psychiatrists. A GP cannot initiate the treatment, although they can prescribe in very limited circumstances, e.g. co-prescribing on behalf of the specialist; and in rural areas, if the patient has been diagnosed with ADHD, a GP may apply for the authority to prescribe. Patients who may require Schedule 8 CNS stimulant medication should be referred to a specialist for assessment.
Examples:
Schedule 9: Prohibited Substance
Schedule 9 drugs and poisons are substances and preparations that, by law, may only be used for research purposes. The sale, distribution, use, and manufacture of such substances without a permit is strictly prohibited by law. Permits for research uses on humans must be approved by a recognised ethics committee on human research.Examples:
- 2C-I
- Benzylpiperazine
- Bromo-DragonFLY
- Coca leaf
- DMT
- Harmine/Harmaline
- Heroin
- Kratom, also known as Mitragyna speciosa; as well its main alkaloid Mitragynine
- LSD
- MDPV
- Mephedrone
- Mescaline
- Methaqualone
- Methoxypiperamide
- Salvia divinorum
Schedule 10: Substances of such danger to health as to warrant prohibition of sale, supply and use
Examples are:
- 2,4-Dinitrophenol for human use
- Borage for therapeutic use except the fixed oil derived from the seeds of Borago officinalis.
- Coal tar for cosmetic use other than in therapeutic goods.
- Juniperus sabina for therapeutic use
- Oxyphenisatin for therapeutic use
Unscheduled substances
Examples:
- Antacids
- Alcohol
- Caffeine
- Ephenidine
- Hydroxymorphinan
- Paracetamol 500 mg in small packs
- Some laxatives
- Lubricant eye drops
- Nicotine replacement therapy