In short
Good Medical Practice requires that every prescription is clinically indicated and in the patient's best interests. Prescribing of drugs of dependence, such as opioids and benzodiazepines, is closely monitored, requires the correct authorisations, and is now checked against real-time prescription monitoring. Self-prescribing, and prescribing drugs of dependence for people close to you, is prohibited. Inappropriate prescribing can lead to immediate action, loss of prescribing authority, disciplinary action and, in some cases, criminal charges. If a prescribing notification is made, get advice quickly.
What does the standard require for prescribing?
That every prescription is clinically indicated, in the patient's best interests, and supported by proper assessment and records.
The core rule
Under Good Medical Practice, you should satisfy yourself that every prescription is clinically indicated and in the best interests of the patient, based on an adequate assessment, with the risks and benefits considered and documented.
Most prescribing concerns come back to this rule. A prescription written without adequate assessment, without a clear indication, or without documenting the reasoning, is where problems begin. It is worth remembering that the great majority of doctors prescribe safely every day, and that a strong, well documented clinical rationale is your best protection. For the overall process, see our guide to what happens after a notification to the Medical Board.
Why is prescribing drugs of dependence higher risk?
Because opioids, benzodiazepines and other Schedule 8 medicines carry real harm and are governed by strict authorisation rules.
Prescribing drugs of dependence is one of the most scrutinised areas of medical practice. Schedule 8 medicines and other drugs of dependence generally require the correct authorisation or permit from the relevant state or territory health department, and prescribing is now checked against real-time prescription monitoring systems that flag high-risk patterns. Prescribing an S8 without the required authorisation, in excess of a permit, or without proper assessment of pain and risk, is exactly the kind of conduct that leads to serious action. Adequate clinical notes and a documented management plan are essential.
Can you prescribe for yourself or family?
No, not for drugs of dependence; Good Medical Practice prohibits self-prescribing and prescribing these medicines for anyone close to you.
The code prohibits self-prescribing and prescribing Schedule 8, psychotropic medication or drugs of dependence for anyone you are close to, such as family, friends or staff. More broadly, wherever possible you should avoid providing medical care to anyone with whom you have a close personal relationship, because objectivity and proper assessment are compromised. Prescription monitoring systems now make these prescriptions easy to identify, so a well-meant script for a family member can become a notification.
What are the common prescribing red flags?
Patterns that regulators and monitoring systems watch for, and that commonly feature in notifications.
- Prescribing an S8 or drug of dependence without the required authorisation
- Continuing to prescribe after being advised a patient is high risk or drug-seeking
- Excessive prescribing without proper assessment or a documented plan
- Prescribing dangerous medicines to patients you do not know
- Combining opioids and benzodiazepines without clear justification
- Inadequate clinical notes to support the prescription
How should you handle drug-seeking behaviour?
You are entitled, and expected, to decline or reduce a prescription that is not clinically justified.
Doctors who want to help patients in pain can feel pressured into inappropriate prescribing, and manipulative or drug-seeking behaviour is a recognised challenge. The regulator supports doctors who stand firm. Refusing to prescribe, or reducing a dose, where it is not clinically justified is exactly what the Board wants to see, and complaints about a doctor declining to prescribe are considered very differently from those about over-prescribing. Use real-time prescription monitoring, set clear expectations, put safety processes in place for opioid requests, and offer to continue care on the basis of a proper plan. Any coercion or threat is a red flag and a breach of the therapeutic relationship.
How serious is a prescribing notification?
Potentially very serious; it can lead to immediate action, loss of prescribing authority, disciplinary action, or criminal charges.
Because the harm from inappropriate prescribing can be severe, the consequences are significant. The Board frequently takes immediate action to stop a doctor prescribing restricted medicines while a matter is investigated. Outcomes can include conditions, suspension or cancellation, and inappropriate S8 prescribing may also result in criminal prosecution or loss of your authority to prescribe. This is a matter to take advice on without delay.
How should you respond, and how can CPD help?
Get advice quickly, explain your clinical reasoning against the standard, and evidence targeted remediation.
Contact your medical defence organisation immediately. With advice, explain the clinical indication and your assessment for each prescription, mapped to Good Medical Practice, and acknowledge honestly any gap in assessment, authorisation or documentation. Evidence remediation such as targeted prescribing CPD, a changed process for drugs of dependence, and use of prescription monitoring. Structured CPD on prescribing guidance and standards, aligned with your CPD registration standard, gives dated evidence that you have addressed the concern and strengthened your prescribing. Browse the range of CPD for doctors.
Illustrative example
The concern: A doctor continued to prescribe opioids to a patient without reassessing pain or documenting a management plan, and monitoring flagged the pattern.
Acknowledge: The doctor accepts the assessment and documentation fell short of the standard, whatever their intention to help.
Reflection: They reflect honestly on how they were drawn into ongoing prescribing without a clear plan.
Remediation: They complete CPD on prescribing drugs of dependence, adopt a structured assessment and tapering process, and use real-time monitoring routinely.
How can you prescribe safely and avoid a notification?
Build a consistent routine so that every prescription, especially of a drug of dependence, can be justified against the standard.
Most prescribing notifications are preventable with disciplined habits. Before prescribing, satisfy yourself the medicine is clinically indicated and in the patient's best interests, based on an adequate assessment. For drugs of dependence, check real-time prescription monitoring, confirm you hold the correct authorisation for the medicine, dose and duration, and document your indication, risk assessment and management plan clearly. Set expectations with the patient, review regularly, and taper where continued prescribing is not justified. Never self-prescribe or prescribe these medicines for people close to you. Approaching every prescription as one you may one day have to explain to the Board is not defensive medicine, it is simply good practice, and it is the surest protection against a notification.
Matched to prescribing concerns
Courses for a prescribing notification
Structured CPD chosen for prescribing and clinical concerns, to help you evidence remediation. Independent CPD you can use as evidence of remediation.
Prescribing Guidance and Standards for Healthcare Professionals
- Directly targets the prescribing concern
- Understand safe, indicated prescribing
- Evidence a strengthened process
Ensuring Clinical Competence and Patient Safety
- Link prescribing to safe assessment
- Strengthen risk assessment and planning
- Evidence competence for your response
How to Ensure a Mistake or Misconduct Is Not Repeated
- Show the Board the concern will not recur
- Turn reflection into a lasting process
- Evidence a sustained safeguard
How to Deal With a Notification or Investigation
- Understand each stage of the Board's process
- Know what to do, and what to avoid, early
- Respond calmly and well prepared
Official sources
Frequently asked questions
Can a doctor prescribe for a family member?
Not drugs of dependence. Good Medical Practice prohibits self-prescribing and prescribing Schedule 8, psychotropic medication or drugs of dependence for people close to you, and advises avoiding care of anyone with whom you have a close personal relationship where possible.
What authorisation do I need for S8 medicines?
Schedule 8 and other drugs of dependence generally require the correct authorisation or permit from your state or territory health department, and rules vary by jurisdiction. Prescribing without the required authorisation is a serious concern.
Will real-time prescription monitoring flag my prescribing?
Real-time prescription monitoring systems flag high-risk patterns of prescribing drugs of dependence. Using them is now part of safe practice, and they make inappropriate prescribing, including for family, much easier to identify.
Can I be reported for refusing to prescribe opioids?
You are entitled to decline or reduce a prescription that is not clinically justified, and the Board supports doctors who do. Complaints about declining to prescribe are considered very differently from those about over-prescribing.
How do I handle a patient seeking inappropriate medication?
Use real-time prescription monitoring, set clear expectations, and offer to continue care on the basis of a proper plan. Refuse or taper where prescribing is not justified. Coercion or threats are a red flag and a breach of the therapeutic relationship.
How serious is an inappropriate prescribing notification?
Potentially very serious. It can lead to immediate action stopping your prescribing, conditions, suspension or cancellation, loss of your authority to prescribe, and in some cases criminal prosecution. Take advice from your medical defence organisation quickly.
What should I do if I receive a prescribing notification?
Contact your medical defence organisation immediately. Explain the clinical indication for each prescription against the standard, acknowledge honestly any gap in assessment, authorisation or documentation, and evidence remediation such as targeted prescribing CPD.
Does CPD help with a prescribing notification?
Yes. CPD on prescribing guidance and standards, aligned with your CPD registration standard, gives dated evidence that you have addressed the concern and strengthened your prescribing. It never guarantees an outcome, but it directly addresses the concern.
Dr Richard
Course Facilitator
A practising clinician with over 21 years of experience and postgraduate training in healthcare law and ethics, so every course reflects both clinical reality and Australian regulatory standards.
Written and reviewed by Dr Richard. Last reviewed . Read full profile
AHPRA Courses is an independent training provider. Our courses are structured CPD that practitioners can use as evidence of remediation. We are not affiliated with, endorsed by, or acting on behalf of Ahpra, the Medical Board of Australia, or any other regulator. Courses provide evidence of remediation and do not determine the outcome of any matter. This article is general information, not legal or clinical advice. If you have received a notification, seek advice from your medical defence organisation or a health law solicitor.