Medical Board of Australia v Van Opdenbosch

[2012] QCAT 703

CITATION: Medical Board of Australia v Van Opdenbosch [2012] QCAT 703

PARTIES:	Medical Board of Australia
v
Dr Josse Corneel Van Opdenbosch

APPLICATION NUMBER: OCR298-11

MATTER TYPE: Occupational regulation matters

HEARING DATE: On the papers

HEARD AT: Brisbane

DECISION OF: Kerrie O'Callaghan, Acting Deputy President
Assisted by:
Dr Eleanor Milligan
Dr Stephen Pozzi
Dr Ross Taylor

DELIVERED ON: 12 November 2012

DELIVERED AT: Brisbane

ORDERS MADE:

1.     The conditions listed in Annexure A to these reasons are imposed on Dr Josse Corneel Van Opdenbosch’s registration upon him undertaking not to apply to revoke or vary the imposition of these conditions on his registration.

2.     Dr Van Opdenbosch pay the Board’s costs of and incidental to proceedings on the scale of costs applicable to proceedings in the District Court of Queensland as agreed or to be assessed.

3.     Until further order, publication is prohibited of any identifying information about AH, RH and KH.

CATCHWORDS:

OCCUPATIONAL REGULATION – HEALTH PRACTITIONER – DOCTOR DISCIPLINARY – where the Registrant inappropriately prescribed medications – where Registrant failed to properly examine and diagnose patients – where the Registrant’s prescriptions were excessive in quantity and frequency – where Registrant did not document consultations – where Registrant admitted conduct – where parties presented a jointly proposed sanction – where Tribunal considered the parties' proposed sanction inadequate

Queensland Civil and Administrative Tribunal Act 2009, ss 32, 66
Health Practitioners (Professional Standards) Act 1999, s 124(1)

APPEARANCES and REPRESENTATION (if any):

This matter was heard and determined on the papers pursuant to s 32 of the Queensland Civil and Administrative Tribunal Act 2009 (QCAT Act).

REASONS FOR DECISION

1. Dr Josse Corneel Van Opdenbosch is an 88 year old general practitioner working in a medical centre in Charters Towers.  He obtained his medical qualifications in Belgium in 1950 and has held a variety of positions in Australia since obtaining registration to practice here in 1966.

2. The genesis of this referral was an anonymous complaint to the then Medical Board of Queensland on 20 April 2009.  The complaint raised issues of general competency including concerns about his age and cognitive function and his relationship with a woman, 50 years younger then himself, to whom he was prescribing drugs.  As a result the Medical Board’s Health Assessment and Monitoring Unit (HAM) commenced an assessment of Dr Van Opdenbosch.  Dr Van Opdenbosch underwent a health and psychiatric assessment.  The psychiatrist who conducted the assessment concluded:

   a.“I did not consider it within my brief to conduct a physical examination but Dr Van Opdenbosch appeared generally vigorous and physcially healthy for his age”.

   b.“There is no evidence of psychiatric (including significant cognative impairment).”[1]

   [1]Reported Dr James, Exhibit A to the affidavit of Dr Van Opdenbosch dated 17 August 2012.

3. The Health Assessment and Monitoring Committee recommended to the Board that Dr Van Opdenbosch was not impaired and that the complaint regarding his prescribing practices be referred back to the Board.

4. Before the Board convened to consider the matter it became aware of a further event concerning Dr Van Opdenbosch.

5. The Board received a phone call from Dr Blizzard at the Gladstone Hospital.  She advised that a patient Ms AH had been admitted to the Hospital following a drug overdose.  The Doctor had ascertained that Dr Van Opdenbosch had prescribed medications to AH that were “unusual in terms of the range of drugs and amount”.[2]

   [2]Office of the Medical Board – Assessment Recommendation, Exhibit MBO26 (page 299) to the affidavit of Mathew O’Donnell 30 August 2012, 299.

6. As a result the Board initiated an investigation into Dr Van Opdenbosch’s prescribing practices.  The current referral was the outcome of that investigation.

The conduct

1. The Board submitted in its referral that there were grounds for disciplinary action against Dr Van Opdenbosch pursuant to section 124(1) of the Health Practitioners (Professional Standards) Act1999 in that he had behaved in a way that constituted unsatisfactory professional conduct.

2. The issues which were said to give rise to the grounds centred on inappropriate prescribing of drugs in respect of three patients – AH, RH and KH.

3. The inappropriate prescribing in respect of each patient was alleged to involve:

   a.     A failure to properly examine and diagnose to ensure that prescriptions were medically indicated;

   b.     Prescriptions were excessive in quantity and frequency such as to pose a risk to health and safety; and

   c.     Dr Van Opdenbosch did not properly document any consultation with the patients in respect of the prescriptions.

4. It is relevant to know the background to Dr Van Opdenbosch’s relationship with the three patients which is set out in his affidavit.[3]

   [3]        Affidavit of Josse Corneel Van Opdenbosch dated 7 August 2012.

5. He first met AH in the late 1990s when AH was a member of a water polo team he was coaching.  They began a personal relationship at that point which continued for a short time.  They then lost contact.

6. They met again several years later and resumed their personal relationship.  According to Dr Van Opdenbosch, AH had various medical problems – epilepsy, bleeding and adominal pain.

7. Dr Van Opdenbosch diagnosed AH with adenomyosis.  This was confirmed by her gynaecologist and required a hysterectomy.  Following her hysterectomy AH developed violent left sided pain due to a bowel obstruction.  Dr Van Opdenbosch prescribed pain killers with the intention she receive further treatment.

8. AH has had epilepsy since childhood.  Dr Van Opdenbosch prescribed medication to prevent epileptic fits. 

9. RH is AH’s mother.  He treated her and prescibed medication to treat pain symptoms and inflammation associated with osteoarthritis in her knees.

10. KH was AH’s father and RH’s husband.  He suffered severe metastic melamona.  Dr Van Opdenbosch prescribed medication to treat KH’s pain.  KH died in December 2009 from the cancer.

11. Following a compulsory conference the parties formulated an agreed statement of facts.  The Board decided not to pursue the issues concerning failure to properly examine and diagnose the three patients and the allegation that the prescriptions were excessive in quantity and frequency.  It determined to continue with allegations that Dr Van Opdenbosch failed to properly document consultations with patients in relation to prescriptions, which they submitted amounted to unsatisfactory professional conduct.

12. Dr Van Opdenbosch concedes that:

    a.   He did not keep contemporaneous notes of each occasion that he medically examined, treated or prescribed medications for the patients AH, RH and KH;

    b.   The medical records he produced with respect to AH, RH and KH are not clearly legible such that they would be understandable by another general practitioner or physician; and

    c.   His record keeping with respect to the health records of AH and KH was inadequate. [4]

    [4]        Agreed statement of facts filed 26 July 2012.

13. Maintenance of clear and accurate medical records is essential for the continuing good care of patients and involves:

    a.   Keeping accurate, up to date and legible records that report relevant details of clinical history, clinical findings, investigations, information given to patients, medication and other management;

    b.   Ensuring that records are sufficient to facilitate continuing care; and

    c.   Making records at the time of event or as soon as possible afterwards.[5]

    [5]        Submission on behalf of the Medical Board of Australia filed 4 September 2012.

14. The parties agree, and the Tribunal finds, that in failing to keep adequate medical records Dr Van Opdenbosch has behaved in a way that constitutes unsatisfactory unprofessional conduct in that he has engaged in professional conduct that is of a lesser standard than that which might reasonably be expected of him by the public or his professional peers.[6]

    [6] Section 124(1)(a)(i) Health Practitioners Professional Standards Act 1999.

Sanction

1. The parties reached an agreement on the proposed sanction.  The Board submitted that the proposed sanction was appropriate bearing in mind:

   a.   Dr Van Opdenbosch’s age (88);

   b.   Dr Van Opdenbosch had made some admissions and generally cooperated with the Board in facilitating the proceedings;

   c.   His practice will be closely monitored; and

   d.   He is to undertake further training in relation to appropriate medical record keeping and note taking.

2. Dr Van Opdenbosch also submitted that the sanction was appropriate.  He submitted that inappropriate record keeping per se was likely to be a common place transgression but that in his case there were aggravating features to his failure to keep proper records mainly:

   a.   The nature of the medications prescribed, together with the volumes and frequency of them required properly detailed records;

   b.   The failure to make records in circumstances where there was a personal relationship with the patient makes the failure more substantial and unusual than the ordinary case; and

   c.   The number of occasions for which there was no satisfactory records.

3. The parties submitted that the proposed sanctions fulfilled the statutory obligations of public benefit by permitting Dr Van Opdenbosch to continue to practice but under a regime that prevented risk to the patients involved or any other patients.

4. The proposed sanctions provided for training, assessment and mentoring.  The Tribunal after convening, however, had a number of concerns regarding the proposed sanctions.

5. This was a hearing on the papers.  In such a setting it was not possible to raise the concerns at the time with the parties.  The Tribunal decided to address those concerns in the form of proposed orders inviting the parties to comment on them and then to reconsider its position. 

Concerns relating to the following aspects

1. The Tribunal had concerns in relation to:

   a.   Dr Van Opdenbosch’s health and cognitive capacity;

   b.   Personal supervision of Dr Van Opdenbosch;

   c.   Inconsistencies in the proposed order as to what drugs Dr Van Opdenbosch should be allowed to prescribe;

   d.   Incorrect referencing in the proposed orders; and

   e.   The drugs included in “prohibited drugs”.

Dr Van Opdenbosch’s health and cognitive capacity 

1. This was an issue previously raised by the Board and whilst it was dealt with in 2009 with Dr Van Opdenbosch undergoing a health assessment, the Tribunal queried whether the problems with record keeping admitted to by the doctor may have been related to any health or cognitive concerns.  Accordingly the Tribunal proposed an order requiring an updated health and cognitive assessment. 

2. Dr Van Opdenbosch opposed such orders arguing firstly that where there is an agreement on sanction and the sanction proposed by the parties is within the “permissable range” the tribunal should not depart from it.  The Tribunal does not accept that proposition.  In disciplinary proceedings such as this, the sanction is ultimately a question for the Tribunal to determine and it is open to the Tribunal to depart from any agreed sanction if it considers its appropriate to do so. 

3. The Tribunal does however accept the submission that the unsatisfactory conduct of Dr Van Opdenbosch is not as a consequence of some impairment of his cognitive functioning or other aspect of his health.

4. Not having the benefit of being able to engage in oral submissions it was appropriate to raise this issue through proposed orders.  On the basis of Dr Van Opdenbosch’s submission it is accepted that it is not necessary to order health and cognitive assessments.

Personal supervision

1. The matters raised by Dr Van Opdenbosch as aggravating factors in this case, namely the nature of the medication and the volume and frequency of prescribing, led the Tribunal to be concerned with ensuring that adequate and appropriate record keeping becomes part of Dr Van Opdenbosch’s practice.  Whilst there were proposed training and monitoring in the agreed sanctions the Tribunal considered it was necessary to impose a further level of monitoring and planning which could be achieved though direct supervision.  The Tribunal proposed that Dr Van Opdenbosch undergo monthly professional supervision by a GP, with a focus on record keeping.

2. Dr Van Opdenbosch submitted in response that it would be difficult for him to arrange such personal supervision in the regional town of Charters Towers and if it was to be required it should be able to be done on the telephone.

3. The Tribunal is unconvinced that it would be difficult to find another general practitioner in Charters Towers to undergo a monthly supervision involving a review of Dr Van Opdenbosch records.  The purpose of the condition is for his records to be reviewed.  This could not be done on the telephone.  The proposed order will remain.

Confusion about what drugs Dr Van Opdenbosch should be able to prescribe

1. The orders proposed by the parties were inconsistent.  One proposed order allowed Dr Van Opdenbosch to prescribe schedule 8 drugs in particular circumstances.  This was inconsistent with other orders which prevented him from prescribing schedule 8 drugs at all.

2. In these circumstances the Tribunal put a proposed order to the parties that Dr Van Opdenbosch not be entitled to prescribe schedule 8 drugs.

3. Both parties in response have acknowledged the inconsistency in their proposed orders but said that the intended position was that Dr Van Opdenbosch be allowed to prescribe schedule 8 drugs in limited circumstances where the drug had previously been prescribed within the last twelve months by another health practitioner holding general and specialist registration.  Dr Van Opdenbosch suggested amended orders to deal with this inconsistency and the Tribunal agrees and amends the proposed orders accordingly.

Incorrect referencing

1. In the draft sanction proposed by the parties there was a cross reference in proposed order 24 to another order which made no sense.  The parties have informed the Tribunal that the cross reference was incorrect.

2. Both the confusion regarding the prescribing of schedule 8 drugs and incorrect referencing illustrate the importance of parties ensuring the accuracy of proposed sanctions when the hearing is to take place on the papers.  The Tribunal at an ‘on the papers’ hearing does not have the opportunity to raise these issues with the parties directly.

The addition of sympathomimetic class of drugs to the “prohibited drugs”

1. This was included in the proposed order due to a suggestion by the medical assessors.  The Tribunal accepts the submissions in response of Dr Van Opdenbosch that it is unnecessary to include a class of the drugs not discretely identified in Appendix 8 and not identified by reference to the chemical ingredients.  The class of drugs will not be included.

2. The Tribunal having considered the submissions orders that upon Dr Van Opdenbosch undertaking to the Board that he will not appeal the placement of these conditions upon his registration it is ordered that the conditions set out in annexure A be placed on Dr Van Opdenbosch’s registration.

Costs

1. Dr Van Opdenbosch has agreed to pay the Board’s costs of proceedings on the scale of costs applicable to proceedings in the District Court of Queensland as agreed or as assessed.  The Tribunal makes orders accordingly.

Non-publication order

1. Under section 66 of the Queensland Civil and Administrative Tribunal Act 2009 the Tribunal may make an order prohibiting publication of information enabling a person appearing before the Tribunal or affected by a proceeding to be identified. Under s 66(2), an order prohibiting publication may be made if the Tribunal considers it is in the interest of justice.

1. The Tribunal considers that publishing personal information about persons who are not a party to proceedings is not in the public interest. It is in the public interest not to publish such information in the circumstances where the persons, although the subject matter of the proceeding, have neither participated nor consented to their personal information being publicised. Therefore, I have initiated a non-publication order under section 66 of the QCAT Act as I am satisfied that it is in the interests of justice to prohibit publication of any information identifying AH, RH and KH.

Annexure A

Conditions on the Registration of Dr Josse Corneel Van Opdenbosch

1. Dr Van Opdenbosch must undergo professional supervision by a general medical practitioner (‘the Supervisor’) which will commence 1 month after the date of these orders.  The supervision is to focus on record keeping.

   a)   The Supervisor is to be approved by the Board in writing.

   b)   Dr Van Opdenbosch will meet with the Supervisor on a monthly basis at his place of practice to enable the Supervisor to review his record keeping.

1. The Supervisor will randomly select four of Dr Van Opdenbosch’s cases to review.  In reviewing these cases the Supervisor will consider whether there is a sufficient record of the presenting complaint, clinical findings, diagnostic assessment and management plan.  Dr Van Opdenbosch, for the purpose of this review, will provide to the Supervisor his patient records.

1. The Supervisor will provide to the Board three monthly reports, or as otherwise requested by the Board.

1. Dr Van Opdenbosch must comply with all statutory requirements of continuing professional development.  Dr Van Opdenbosch must provide to the Board evidence of this on an annual basis.

1. Dr Van Opdenbosch must provide the Board with evidence that he has completed at least 20 CME points by 1 February 2013.

1. Dr Van Opdenbosch must provide the Board with evidence of his successful completion of the tertiary course ‘MCM9306 – Issues in General Practice Prescribing’ referred to in paragraph 48 of his affidavit dated 17 August 2012, by 1 February 2013.

1. Dr Van Opdenbosch shall, at his own expense, undertake and successfully complete a training course at tertiary level relating to appropriate medical record keeping and note taking.

   a)   The course must be approved in writing by the Board.

   b)   Dr Van Opdenbosch must submit the details of a course for approval by the Board within two (2) months from the date of the order.

   c)   The course must be successfully completed within twelve (12) months of approval by the Board.

1. Dr Van Opdenbosch must not practise the profession except under the following circumstances –

   a)   at the Charters Towers Medical Centre; or

   b)   any other place as approved in writing by the Board.

2. For the purpose of these orders a “prohibited drug” includes all of the following:

   a)   All pharmaceutical items containing any active ingredient listed within Appendix 8 of the Health (Drugs and Poisons) Regulation 1996, hereafter included as Annexure A;

   b) All pharmaceutical items containing any active ingredient listed within Schedule 8 of the Standard for the Uniform Scheduling of Medicines and Poisons, also known as the Poisons Standard 2011 (and all future amendments and/or editions of same), hereafter included as Annexure B;

c)   Any pharmaceutical items containing the following active ingredients in any concentration: buprenorphine, ephedrine, flunitrazepam, morphine, oxycodone, pseudoephedrine, methylphenidate or any drug of the benzodiazepine class.

1. Dr Van Opdenbosch is not to obtain, purport to prescribe, prescribe, possess, administer, dispense, supply, issue, destroy or otherwise deal with a Prohibited Drug other than as permitted by these orders.

1. Dr Van Opdenbosch is not to induce, persuade, encourage, direct, incite or attempt to induce, persuade, encourage, direct or incite any other person to obtain, prescribe, possess, administer, dispense, supply, issue, destroy or otherwise deal with a Prohibited Drug.

1. Dr Van Opdenbosch may only write repeat prescriptions for himself for medications prescribed to him by another practitioner (the ‘Prescribing Doctor’) for his eye condition.  The dosage and quantities must be the same as that prescribed by the Prescribing Doctor.

1. Dr Van Opdenbosch may possess pain killing drugs which have been personally prescribed to him for his own personal use by a specialist.  The pain killing drugs Dr Van Opdenbosch may have in his possession must be in accordance with any prescription and in the quantities only as prescribed.

1. Dr Van Opdenbosch may only prescribe Prohibited Drugs to a patient where that patient has been independently prescribed those drugs by a treating specialist or treating general practitioner.

   a)   Dr Van Opdenbosch shall be limited to a period of twelve (12) months from the date of the first prescription, for prescribing the drug in question as prescribed by a treating specialist or a treating GP for that patient.

   b)   Dr Van Opdenbosch is not to prescribe in excess of the manufacturer's recommended dosages and always in accordance with any drug prescribing protocols as provided under the law.

1. Dr Van Opdenbosch is to provide a monthly report in writing to the Board detailing:

a)   Any pain-killing drugs he currently may hold or has held in the previous month in accordance with condition 13; and

b)   The name, date and particulars of prescription where he has prescribed drugs to any patients in accordance with condition 14.

1. For the purposes of conditions 17 and 18, the following persons are a “Prohibited Person”:

a)   AH;

b)   RH;

c)   Any person who is known to the practitioner as the persons listed in 19 a) or 19 b) who is or may be using any other name.

1. Dr Van Opdenbosch is not to give a Prohibited Person access to his place of practice except where that person is being treated by another registrant medical practitioner at the premises.

1. Dr Van Opdenbosch is not to consult with, examine, treat, advise or prescribe to a Prohibited Person except in the case of a genuine medical emergency where a failure to provide the treatment would, because of the presentation and the unavailability of alternative care, place the person in serious danger to the person’s health, and where the registrant as soon as practicable hands over the care of the patient to an ambulance officer, another medical practitioner or a hospital.

1. Dr Van Opdenbosch must authorise the Board (or their delegates) to contact and exchange information (by any means necessary) with any pharmacist who dispenses medication generated by him.

1. Dr Van Opdenbosch must authorise the Board to access, or inspect, or obtain copies of his patients’ medical and Medicare records.  Any copies required are to be provided to the Board at Dr Van Opdenbosch’s expense.

1. Dr Van Opdenbosch must authorise the Board (or their delegates) to contact and exchange information (by any means necessary) with any medical practitioner who prescribes medication at the request of Dr Van Opdenbosch.

1. Dr Van Opdenbosch must authorise the Board (or its delegate) to access, inspect, take or copy the patient / practice records, including patient and prescribing records, and appointment diaries at such time or times as determined by the Board (or its delegate) for the purposes of monitoring compliance with these orders.

1. Dr Van Opdenbosch must authorise Medicare Australia and any health insurance funds to release to the Board (or its delegate) any information relating to his practise of medicine at such time or times as determined by the Board (or its delegate).

1. Dr Van Opdenbosch authorises the Board (or its delegate), and the relevant drug regulation units of the relevant State and/or Territory to exchange information at such time or times as determined by the Board (or its delegate), for the purpose of monitoring and ensuring compliance with these orders.

1. Within fourteen (14) days from the date of these orders Dr Van Opdenbosch will provide the Chief Executive, Queensland Health, with a copy of these orders and request pursuant to section 28 of the Health (Drugs and Poisons) Regulation 1996 for an amendment to his endorsement so as to give effect to these orders.

1. Within fourteen (14) days of requesting such an amendment from the Chief Executive, Queensland Health, Dr Van Opdenbosch will provide documentary evidence to the Board of his request.

1. Dr Van Opdenbosch will not remove, take, provide, give, issue (or allow, by either act or omission, another person to provide, give or issue) to any other person, prescription pads or stationery from his place of practice.

1. Within seven (7) days of the date of these orders Dr Van Opdenbosch will provide a copy of these conditions to all employers/partners/contractors of health services in any practice/facility in which he may practise.

1. Within seven (7) days of notifying persons described in order 28, Dr Van Opdenbosch will advise the Board in writing of the names and contact details of those persons.

1. Conditions 16-18 inclusive must not be publicly recorded on the register for privacy considerations.  All other conditions must be publicly recorded permanently on the register.

1. Dr Van Opdenbosch undertakes that he will not apply to the Tribunal to review these conditions.

Conditions on the registration of Dr Josse Corneel Van Opdenbosch
Annexure A

Health (Drugs and Poisons) Regulation 1996

Appendix 8 Restricted drugs of dependency

acetyldihydrocodeine
adiphenine
alprazolam
amyl nitrite
amylobarbitone
barbiturates, other than barbiturates individually listed in this appendix
benzhexol
benzodiazepines, other than benzodiazepines individually listed in this appendix
bromazepam
chloral hydrate
chlordiazepoxide
clobazam
clonazepam
clorazepate
codeine
dexfenfluramine
dextromethorphan
dextropropoxyphene
dextrorphan
diazepam
diethylproprion
dihydrocodeine
ephedrine
ethylmorphine
fenfluramine
lorazepam
mazindol
medazepam
meprobamate
midazolam
nitrazepam
oxazepam
pentobarbitone
phentermine
propylhexedrine
temazepam
triazolam

zolazepam

Conditions on the registration of Dr Josse Corneel Van Opdenbosch
Annexure B

Standard for the Uniform Scheduling of Medicines and Poisons

Schedule 8
ACETYLDIHYDROCODEINE.
ACETYLMETHADOL.
ACETYLMORPHINES.
ALFENTANIL.
ALPHACETYLMETHADOL.
ALPHAPRODINE.
AMPHETAMINE.
AMYLOBARBITONE except when included in Schedule 4.
ANILERIDINE.
BENZYLMORPHINE.
BEZITRAMIDE.
BUPRENORPHINE.
BUTOBARBITONE.
BUTORPHANOL.
CARFENTANYL.
COCAINE.
CODEINE except when included in Schedule 2, 3 or 4.
CODEINE-N-OXIDE.
CONCENTRATE OF POPPY STRAW (the material arising when poppy straw has entered into a process for concentration of its alkaloids).
4-CYANO-1-METHYL-4-PHENYLPIPERIDINE (Pethidine intermediate A).
CYCLOBARBITONE.
DEXAMPHETAMINE.
DEXTROMORAMIDE.
DEXTROPROPOXYPHENE except when included in Schedule 4.
DIFENOXIN except when included in Schedule 4.
DIHYDROCODEINE except when included in Schedule 2, 3 or 4.
DIHYDROMORPHINE.
DIPHENOXYLATE except when included in Schedule 3 or 4.
DIPIPANONE.
DRONABINOL (delta-9-tetrahydrocannabinol) when prepared and packed for therapeutic use.
DROTEBANOL.
ETHYLAMPHETAMINE.
ETHYLMORPHINE except when included in Schedule 2 or 4.
FENTANYL.
FLUNITRAZEPAM.
HYDROCODONE.
HYDROMORPHINOL.
HYDROMORPHONE.
KETAMINE.
LEVAMPHETAMINE.
LEVOMETHAMPHETAMINE.
LEVOMORAMIDE.
LEVORPHANOL (excluding its stereoisomers).
METHADONE.
METHYLAMPHETAMINE.
METHYLDIHYDROMORPHINE.
METHYLPHENIDATE.
1-METHYL-4-PHENYLPIPERIDINE-4-CARBOXYLIC ACID (Pethidine intermediate C).
MORPHINE.
MORPHINE METHOBROMIDE.
MORPHINE-N-OXIDE.
NABILONE.
NABIXIMOLS (botanical extract of Cannabis sativa which includes the following cannabinoids: tetrahydrocannabinol, cannabidiol, cannabinol, cannabigerol, cannabichromene, cannabidiolic acid, tetrahydrocannabinolic acid, tetrahydrocannabivarol, and cannabidivarol, where tetrahydrocannabinol and cannabidiol (in approximately equal proportions) comprise not less than 90 per cent of the total cannabinoid content) in a buccal spray for human therapeutic use.
NORCODEINE.
NORMETHADONE.
OPIUM except the alkaloids noscapine in Schedule 2 and papaverine when included in Schedule 2 or 4.
OXYCODONE.
OXYMORPHONE.
PENTAZOCINE.
PENTOBARBITONE except when included in Schedule 4.
PETHIDINE.
PHENDIMETRAZINE.
PHENMETRAZINE.
PHENOPERIDINE.
4-PHENYLPIPERIDINE-4-CARBOXYLIC ACID ETHYL ESTER (Pethidine intermediate B).
PHOLCODINE except when included in Schedule 2 or 4.
PIRITRAMIDE.
PROPIRAM.
QUINALBARBITONE.
RACEMORAMIDE.
REMIFENTANIL.
SECBUTOBARBITONE.
SUFENTANIL.
TAPENTADOL.
THEBACON.
THEBAINE.
TILIDINE.