The Ministry acknowledges the importance of Cabinet making the decision today to reduce the maximum limit for opioid prescriptions from 3 months to 1 month.
This new limit will apply to both Class B and Class C opioids, this is because we know that the risk of harm exists for all opioids. This will bring the prescribing limit for Class C opioids – such as codeine – in line with Class B opioids. The change will reduce the risk of harm associated with opioid prescribing while ensuring regular clinical review and continued access to these medicines.
These changes will also simplify prescribing limits for all prescribers of controlled drugs and are planned to come into effect later this year.
In the interim, there are a number of safeguards in place to manage the risk of opioid prescribing. These include regulations that set out who can prescribe these medicines, monitoring of prescribing practices, clinical guidance that determines appropriate practices, professional sanctions where inappropriate prescribing occurs and Pharmac’s Pharmaceutical Schedule, which provides subsidisation criteria that limits the amount of Class B opioids that may be prescribed and dispensed at one time.
These changes are being made following changes being made to controlled drug prescribing regulations in the Misuse of Drugs Amendment Regulations 2022 last year. The primary intent of those changes was to improve access to Class B controlled drugs for people living with chronic conditions such as ADHD, cancer and those in palliative care.
Due to the safeguards in place, including the Pharmac Schedule not being changed, these changes have not had a practical effect on prescribing practice.
Following the change, Manatū Hauora received feedback from clinical advisors and professional regulators that a maximum 1-month prescription was more appropriate to balance these medicines’ risk of harm with their value in managing pain. This initiated a review by a group health experts, which has since resulted in the decision restore the prescription limits to 1 months for Class B opioids given the updated understanding of the risk profile such opioids involve.
