Review Article
Legal Challenges Facing Prescriptive Authority for Clinical Psychologists in South Africa: Current Issues and Controversies
Thabani Sibanda*
Issue:
Volume 9, Issue 1, March 2025
Pages:
1-12
Received:
6 January 2025
Accepted:
24 January 2025
Published:
27 February 2025
Abstract: Prescription privileges for psychologists (RxP) refer to the ability of appropriately trained psychologists to prescribe psychotropic medications to their patients. There are clear arguments that support or dismiss treatment privilege for psychologists. The movement for prescription privileges for psychologists has been a gradual and ongoing process, with significant progress made in recent decades. The field of psychologist prescribing is still relatively new, and more research is needed to fully understand its impact on patient care. However, the available evidence suggests that prescribing psychologists can provide safe and effective mental healthcare. At present, prescribing rights for psychologists are being considered in Canada, the United Kingdom, and Australia. In most Latin American countries, clinical psychologists are not legally authorized to prescribe medication. In the exception of a few countries, such as Mexico and Brazil. In South Africa, the Health Professions Council of South does not authorize clinical psychologists to prescribe psychotropic medication. The American Psychological Association (APA) has indeed played a significant role in the movement to grant prescription privileges to psychologists. In 2011, the APA published a comprehensive set of practice guidelines for psychologists involved in pharmacotherapy. In this paper review of countries that have facilitated or are in the process of doing so are reviewed. The legislation governing the profession of psychologists in relation to prescriptive authority in South Africa is reviewed and recommendations made. The psychologists in South Africa will have to address the misconceptions and legal ramifications in similar ways as the USA in order to get acceptance.
Abstract: Prescription privileges for psychologists (RxP) refer to the ability of appropriately trained psychologists to prescribe psychotropic medications to their patients. There are clear arguments that support or dismiss treatment privilege for psychologists. The movement for prescription privileges for psychologists has been a gradual and ongoing proces...
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Research Article
Clinical Factors Associated with Opioid Use in Abortive Headache Treatment Among Adolescents in the Emergency Department: Who Gets Them and Why
Issue:
Volume 9, Issue 1, March 2025
Pages:
13-19
Received:
6 May 2025
Accepted:
20 May 2025
Published:
19 June 2025
DOI:
10.11648/j.cnn.20250901.12
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Abstract: Background: Routine use of opioids for headache can lead to worsening symptoms and may contribute to dependence. This study’s main objective was to determine the prevalence and clinical factors associated with opioids used as abortive therapy, for adolescents presenting with headache, in a pediatric emergency room. Methods: We reviewed electronic medical records of youth aged 11 through 21 years presenting to a large suburban pediatric emergency department between January 2014 and December 2020, who were prescribed opioids for headache. Charts were analyzed for demographics, medications prescribed, clinical characteristics, and final diagnoses. Results: 204 youths were seen for headache and received an opioid abortive medication for it. Among those 70 received it for a procedure such as lumbar puncture. Of the remaining 134 patients – 126 received morphine, 28 – hydromorphone/hydrocodone, 26 – oxycodone, tramadol – 9, meperidine – 6, codeine/fiorcet/fentanyl – 8, and methadone – 1. Over half the patients (n=118, 58%) were female, 24% (n=49) had a prior headache history, 20% (n=41) seen a neurologist, and 30% (n=62) had a past psychiatric history. In terms of headache specific factors, only 15% (n=31) were on daily headache prophylaxis. Notably 46% (n=93) had a history of prior opioid use and only 9% (n=18) had used an ergot medication. Conclusion: Youth receiving opioids for headache treatment were more likely to be female, had significant mental health comorbidity, and without access to specialty neurology care. Our findings may help identify youth headache sufferers at risk for opioid use and highlight the need for early identification and referral to a neurologist.
Abstract: Background: Routine use of opioids for headache can lead to worsening symptoms and may contribute to dependence. This study’s main objective was to determine the prevalence and clinical factors associated with opioids used as abortive therapy, for adolescents presenting with headache, in a pediatric emergency room. Methods: We reviewed electronic m...
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