Latest news with #JustinUntersteiner
News.com.au
09-07-2025
- Health
- News.com.au
Major crackdown on medicinal cannabis, doctor writes 17k scripts
Some practitioners have issued more than 10,000 medicinal cannabis prescriptions in just six months, it can be revealed as Australia's health watchdog announces a major crackdown. Authorities have become concerned at 'poor practice' in the burgeoning industry, saying it has led to underage patients receiving scripts and reports of medicinal cannabis-induced psychosis. The Australian Health Practitioner Regulation Agency (Ahpra) and National Boards on Wednesday announced the first official guidelines for prescribing the drug. 'We don't prescribe opioids to every patient who asks for them, and medicinal cannabis is no different,' Medical Board of Australia Chair Dr Susan O'Dwyer said. 'Patient demand is no indicator of clinical need.' The regulators said a lax system had led to fears of profits 'over patient safety', citing reports of 'serious adverse outcomes such as psychotic episodes' for patients whose medical history was not properly considered. One practitioner is believed to have written 17,000 scripts in half a year, while seven others issued more than 10,000 each. Some consultations are lasting 'a few seconds', according to Aphra, and cannabis was being prescribed simply because patients were requesting it. The new guidelines include thorough assessment of patients, taking their medical history into account, creating management plans and continuity of care, maintaining medical records and offering different treatment options. Ahpra chief executive Justin Untersteiner warned practitioners of the inherent conflict of interest for working in an organisation that only prescribes and dispenses a single medicine. 'Some business models that have emerged in this area rely on prescribing a single product or class of drug and use online questionnaires that coach patients to say 'the right thing' to justify prescribing medicinal cannabis,' Mr Untersteiner said. 'This raises the very real concern that some practitioners may be putting profits over patient welfare.' Ahpra has taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices and is investigating 60 more. Mr Untersteiner added Ahpra 'will investigate practitioners with high rates of prescribing any scheduled medicine, including medicinal cannabis, even if we have not received a complaint'. GPs and qualified nurses have been able to prescribe medicinal cannabis for patients under a legal access scheme since 2016. Under the laws they must only make the prescription after identifying a therapeutic need and undertaking a thorough patient assessment. Data from the Penington Institute showed in November that Australians spent $400 million on medicinal cannabis in the first six months of 2024. That was up on the $234 million for the whole of 2022. Ahpra estimated last February that the number of unregistered users of medicinal cannabis products had 'spiralled' from 18,000 in 2019 to more than one million by January 2024. Wayne Hall, a professor at the National Centre for Research on Youth Substance Use Research at the University of Queensland, told The Guardian last year he expected Australia's market to follow a trajectory seen in Canada and the US. 'When you create a medical cannabis program … the pressure is often brought to bear to expand it so it merges into a de facto legal cannabis market for adults,' Prof Hall said. In a statement the Therapeutic Goods Administration welcomed the new guidelines, saying it was working closely with regulators to ensure safe prescription of medicines.
ABC News
09-07-2025
- Health
- ABC News
Concern over medicinal cannabis prescribing
Isabella Higgins: The medical regulator is releasing new guidance for practitioners about the prescribing of medicinal cannabis. It comes after the Australian Health Practitioner Regulation Agency found evidence that poor practices and surging patient demand is leading to significant patient harm. I spoke with National Health Reporter, Elise Worthington, a short time ago. Elise, first of all, what sort of problems has APHRA discovered with the prescribing and use of medicinal cannabis? Elise Worthington: Well, the number of Australians being prescribed medicinal cannabis has absolutely exploded in the past few years. And that's come about as medicinal cannabis telehealth companies have popped up, offering a really convenient, quick way for patients to get prescriptions after short online consultations. But the regulator is concerned that there's been a lack of due diligence by doctors who aren't taking proper medical histories and might be influenced by the companies they work for, which are also selling the products they're prescribing. So we've previously reported that APHRA has actually discovered more than half a dozen doctors have written over 10,000 medicinal cannabis scripts in a six month period. And they found one who'd written more than 17,000. So that equals about one every four minutes in a working day, which has really raised questions for them about how thoroughly patients are being screened. Now APHRA CEO, Justin Untersteiner said that has led to concerns about patient safety. Justin Untersteiner: We are concerned by reports of patients presenting to emergency departments with medicinal cannabis induced psychosis. We're also seeing evidence of over-servicing of patients, as well as ethical grey areas around cannabis only retail facilities. Some business models that have emerged in this area rely on prescribing a single product or a class of drug. And they use online questionnaires that we feel coach patients to say the right thing to justify prescribing medicinal cannabis. Isabella Higgins: That's APHRA's CEO, Justin Untersteiner. And Elise, has APHRA taken any action so far? Elise Worthington: Yes, so APHRA is working with other agencies like the Therapeutic Goods Administration. Now doctors have to report to the TGA, their medicinal cannabis prescriptions that they write. So APHRA is looking at the data and they have said today that they've taken action against 57 prescribers and they're now investigating another 60 doctors, pharmacists and nurse practitioners who can also prescribe medicinal cannabis. And they're really putting doctors working at these telehealth companies on notice that even if there's not a complaint from a patient, they will be asking questions about how they're writing so many scripts, checking their notes and medical records to ensure that patients are actually being properly assessed. Isabella Higgins: And what exactly is in this new guidance for practitioners in how they prescribe and what does APHRA hope they achieve? Elise Worthington: There's actually really strong evidence taking a step back that medicinal cannabis can really help with things like treating childhood epilepsy, muscle spasms, pain associated with multiple sclerosis and cancer, as well as chemotherapy-induced nausea and vomiting. But interestingly, that is not the main conditions that it's being prescribed for in Australia. So we can see that it's mainly being prescribed for things like insomnia, anxiety and chronic pain. So the guidance is quite interesting in that it really clearly states that medicinal cannabis should never be prescribed as a first-line treatment because it's an unapproved therapy for most conditions, excluding some of those ones I mentioned earlier. But that also means that it's not checked for safety, quality or efficacy by the TGA. And the guidelines state that there's not good evidence showing that it works for a lot of other conditions and patients need to be explicitly informed of that when they're being prescribed it. Isabella Higgins: Elise Worthington reporting.
ABC News
08-07-2025
- Health
- ABC News
AHPRA takes action against more than 50 practitioners in medicinal cannabis crackdown
The health-practitioner watchdog has put medicinal cannabis prescribers on notice, saying poor prescribing practices and surging consumer demand are leading to "significant" patient harm. AHPRA today released new guidelines urging prescribers to put patient wellbeing above profits, as medicinal cannabis prescriptions rise rapidly due to telehealth companies providing a one-stop shop for quick access to medicinal cannabis. The regulator said some businesses were using "aggressive and sometimes misleading advertising that targets vulnerable people" and online questionnaires that coached patients to say "the right thing" to justify prescribing. The ABC can reveal AHPRA has now taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices. "We're currently investigating a further 60 right now as we speak. And for those that choose not to meet our requirements, we will be knocking on their door in the near future," AHPRA chief executive Justin Untersteiner said. The crackdown comes after a series of ABC investigations revealed patients with a history of psychosis had been hospitalised after being prescribed medicinal cannabis and one patient had died following inappropriate prescribing. The investigations also revealed concerns from doctors who said they were being treated like drug dealers and pressured to write medicinal cannabis scripts by the telehealth companies. While AHPRA said the majority of practitioners do the right thing, the agency uncovered half a dozen who issued more than 10,000 scripts in a six-month period, including one who issued over 17,000, or one every four minutes in a working day. Mr Untersteiner said the regulator held serious concerns for patient safety due to excessive and inappropriate prescribing. "We've seen patients present to emergency departments with medicinal-cannabis-induced psychosis, and this can particularly happen where there are patients that have pre-existing mental health conditions or substance abuse or other issues like that. "Another area that worries us is … prescribing excessive quantities or even prescribing multiple different prescriptions to a single patient so they can try which one suits them. "Again, that's completely inappropriate," he said. The new AHPRA guidelines explicitly state that except for childhood epilepsy, muscle spasms and pain associated with multiple sclerosis, cancer and chemotherapy-induced nausea and vomiting, "there is little evidence to support the use of medicinal cannabis". According to Therapeutic Goods Administration (TGA) data, the main conditions medicinal cannabis is being prescribed for include insomnia, chronic pain and anxiety. The guidelines state medicinal cannabis should not be prescribed as a first-line treatment and should only be used when there is an evidence-supported clinical indication and when other treatments have not worked. They also insist patients be thoroughly assessed, proper medical records be taken, and an exit strategy is developed to help patients stop taking the medication. Most medicinal cannabis products prescribed in Australia are unapproved, meaning they have not been assessed by the TGA for safety, quality, performance or effectiveness, something patients must now be informed of during consultations. The majority of cannabis products prescribed in Australia also contain THC, which causes psychoactive effects and makes them Schedule 8 medicines due to the risks of misuse, abuse and potentially addictive properties. "We don't prescribe opioids to every patient who asks for them and medicinal cannabis is no different. Patient demand is no indicator of clinical need," Medical Board of Australia Chair, Dr Susan O'Dwyer said. AHPRA and the Medical and Nursing and Midwifery Boards said they were working with other regulators like the TGA and may investigate practitioners with high rates of prescribing even without receiving complaints. Patients and doctors are encouraged to report unsafe practices to help protect others by calling the AHPRA Notifications Hotline on 1300 361 041.
News.com.au
16-06-2025
- Health
- News.com.au
Health watchdog warns public warned about suspended dentist Peter Terzi
The public have been warned about a dentist who was suspended by the health watchdog but may still be operating on patients. Australian Health Practitioner Regulation Agency (AHPRA) released its first public statement under new laws to warn consumers about Peter Terzi, also known as Peter Taylor, who held a dual dentist and nurse registration. Mr Terzi is under investigation and was suspended from practising both professions in February this year. AHPRA allege the suspended Western Australian practitioner poses a serious risk to people because of his conduct. 'He remains under investigation and AHPRA believes he may be continuing to present himself as a registered dentist or nurse while he is suspended and unregistered,' the statement read. Mr Terzi is facing criminal charges for recklessly holding himself as a registered dentist and carrying out a restricted dental act and is before the court. He pleaded not guilty to the charges. AHPRA chief executive officer Justin Untersteiner said the power to issue a warning to the general public came into force two years ago, but Monday's public statement is the first time these powers have been used. 'We take the matter of issuing public statements very seriously and will only ever issue such statements in exceptional circumstances where the public needs to be informed from a safety perspective,' he said. 'The threshold for issuing a public statement is set at a high level. The decision to issue a public statement may only be made when AHPRA or a National Board form a reasonable belief that a practitioner or person poses a serious risk to the public. 'Issuing this statement today means we can warn the public while we continue to take steps to assess and investigate matters that could raise a serious risk to the public.' Anyone who suspects they may have received treatment from or employed Peter Terzi/Taylor, or who has information that he has claimed to be a dentist or a nurse since February 26, is urged to contact AHPRA's Criminal Offences Unit.
ABC News
02-06-2025
- Business
- ABC News
Health practitioner regulator gets tough on cosmetic injectable industry to protect patient safety
The Australian health practitioner regulator has introduced sweeping new guidelines for dentists and nurses performing non-surgical cosmetic injectable procedures, in a bid to better protect the public from players putting profits ahead of patient safety. The new rules released by the Australian Health Practitioner Regulation Agency (AHPRA) today mandate further education and training before healthcare practitioners can perform cosmetic procedures like botox and filler injections. They also introduce minimum periods of experience required for nurses wanting to work with injectables. Nurses and dentists have been operating in the billion dollar cosmetic injectable industry for years without being required to undertake any formal additional education or training, before injecting patients with neurotoxins like botox. While many have become highly skilled at the practice, there's concern clearer rules are needed for those wanting to enter the industry to ensure they have enough training. Under the changes, advertisements will be required to include the details of the registered practitioner performing the procedures. Testimonials from social media influencers will be banned, along with targeted advertising of cosmetic procedures to minors. AHPRA CEO Justin Untersteiner said not all cosmetic injectors would be happy with the tighter rules and expected some would choose to leave the industry under the changes. "There will be others who have to modify their business models, and modify their practices to meet these guidelines," he said. Nurses and dentists have until September to prepare for the changes and ensure they are compliant with the new guidelines, which align with those already in place for doctors. "[After that] we will be identifying those that are doing the wrong thing and we will take action where we need to," he said. There's been a recent spate of cases of non-registered practitioners and clinics using off-brand or out-of-date dermal fillers and botox on patients leading to multiple hospitalisations after patients became ill with botulism. The NSW Health Care Complaints Commission (HCCC) warned patients of a Sydney cosmetic clinic to be tested for blood borne viruses after finding evidence that non-registered staff were injecting patients with dermal fillers and botox. The new federal guidelines are the latest salvo from state and federal regulators, who have been cracking down on cosmetic injectable providers, throwing some clinics into chaos as they scramble to ensure they comply with regulations. Many injectable businesses around the country are run by nurses who do the injecting, and often hold supplies of prescription fillers and anti-wrinkle injections like botox on site, and arrange telehealth consults for their patients so doctors can remotely prescribe the products. Recent guidance released in Queensland has made it clear the practice isn't legal unless the nurse is a Nurse Practitioner with prescribing rights and additional qualifications, or there's a doctor on site. State pharmaceutical and poisons regulators in both NSW and Queensland have also been conducting compliance checks on clinics, monitoring the possession and storage of schedule 4 medications like botox and fillers. AHPRA said it was concerned some telehealth practitioners weren't meeting their professional obligations, after media reports revealed patients were sometimes being issued botox scripts in less than a minute. The new guidance from AHPRA reinforced practitioners were responsible for understanding relevant state and federal drugs and poisons laws, and that those who prescribed cosmetic injectables were still responsible for the patients, regardless of whether or not they performed the procedure. The guidelines also mandate written information must be given to the patient, including the health practitioner who prescribed the cosmetic injectable, the practitioner who performed the procedure, details of the products used, what aftercare was needed, and who is responsible for coordinating the patient's care. From September, nurses will be required to complete a set period of 12 months of full-time practice before expanding their scope to include non-surgical cosmetic procedures. The guidelines state further education will be necessary for those practitioners wanting to work with cosmetic injectables. Those practitioners will need training in anatomy and physiology, education in assessing patients for suitability for the procedure, and both theoretical and hands-on training in the specific procedure being offered. While AHPRA CEO Justin Untersteiner said there had always been an obligation for practitioners to ensure they had appropriate skills, the new rules were "really making it crystal clear" about what it expected for those sorts of procedures. "That will likely require specific training around facial anatomy or physiology and I can tell you that is not a weekend course, this is proper training that will be required," Mr Untersteiner said. He said the regulator had heard multiple cases of permanent irreversible facial nerve damage as well as potentially life-threatening strokes from cosmetic injectables. "All registered health practitioners are responsible for ensuring they are sufficiently educated, trained and competent to safely undertake any cosmetic procedure they may perform." Do you have a story to share? Email Nursing and Midwifery Board of Australia chair, Veronica Casey, welcomed the new guidelines and said the safety of the Australian public was paramount. "These types of procedures are undertaken every day and can have serious consequences if not done correctly," she said. The new AHPRA regulations outline that "registered health practitioners must also disclose any financial interests that could be perceived as influencing the advice they provide to people about cosmetic procedures". Some doctors and nurses working in cosmetic injectable clinics operate on commission-based models, meaning the more work done or greater the volume of product injected, the more money they stand to make from a consultation. But whether commission-based models need to be disclosed to patients will be subject to clinician's judgement and assessed by the regulator on a "case-by-case basis". It is illegal to advertise almost all prescription medications or related services including cosmetic injectables, with the Therapeutic Goods Administration (TGA) responsible for regulation. Despite this, cosmetic clinics have been widely flouting advertising rules for years on social media and their own websites. The TGA said it had recently sent around 100 "targeted guidance letters" to providers in the cosmetic injectables industry, following identification of alleged non-compliance and that more will follow "in the coming weeks". The agency said in a statement that last financial year it submitted over 12,000 requests for removal to social media platforms over the alleged unlawful advertising of therapeutic goods, including "over 2,500 advertisements relating to cosmetic injectable products". The AHPRA guidelines now state any imagery used in advertising of higher-risk cosmetic procedures must be focused on information or education, citing concerns advertising was promoting the "trivialization and glamourisation" of cosmetic procedures to vulnerable patients, especially on social media. Examples of features more likely to be considered entertainment included imagery like music, dancing, singing, or comedic comments. It comes almost four years after a joint ABC and Sydney Morning Herald investigation revealed a shocking video of two doctors dancing while performing liposuction on an unconscious patient, which led to a crackdown on the cosmetic surgery industry. Under the new injectables guidelines there will be a total ban on targeted advertising towards patients under 18, as well as a mandatory seven-day cooling off period between the first consultation and any procedures for minors. Patients considering cosmetic injectables have been encouraged to check if a health practitioner is registered on the Australian Health Practitioners Regulation Agency website.
