Alprazolam for prescribers and pharmacists
Alprazolam is a rapid-onset, short-acting benzodiazepine indicated for treatment of anxiety disorders and panic attacks. Ideally alprazolam should be prescribed for short periods, such as two to four weeks.
In South Australia alprazolam abuse especially in drug dependent populations is being reported more frequently. This is similar to other Australian jurisdictions. Large pack sizes and a sought-after pharmacological profile makes alprazolam the benzodiazepine of choice amongst drug dependent populations.
In response to these and other concerns, Alprazolam was rescheduled by the Therapeutic Goods Administration in February 2014. Alprazolam now has similar controls as other drugs of dependence, such as morphine and dexamphetamine. These controls require doctors, nurses and pharmacists to follow certain legal requirements.
What this means for you:
- A statutory authority (section 18A Controlled Substances Act 1984) from the Drugs of Dependence Unit is required for extended treatment with alprazolam, as with other Schedule 8 treatment.
- An authority is not required for patients aged 70 years or more, or whose life expectancy is reasonably believed to be less than 12 months and the Drugs of Dependence Unit has been notified of this.
- Applications for an authority should be accompanied by a report from a psychiatrist or other relevant specialist that provides an assessment of your patient’s condition and ongoing treatment with alprazolam.
Where can I get more information and advice?
For more information or advice on:
- scheduling change to alprazolam visit the Therapeutic Goods Administration website
- your legal obligations for prescribing alprazolam contact the Drugs of Dependence Unit, email HealthDrugsofDependenceUnit@sa.gov.au or phone 1300 652 584
- clinical advice on transferring patients from alprazolam or managing benzodiazepine withdrawal contact Drug & Alcohol Clinical Advisory Service (24 hour service for health practitioners) on (08) 7087 1743
- mental health emergency, contact the Mental Health Triage Service (24 hour service), phone 13 14 65.
Signs of potential misuse of alprazolam
- Reports of lost / stolen prescription or medication
- patient specifically requests drug by name
- patient exhibits demanding or intimidating behaviour
- presenting intoxicated
- new patient to clinic and no previous medical reports available
- signs of recent or past injecting
- patient unwilling to engage in treatment as outlined in the Guidance.