Thank you to Oscar who in a comment on my post Authority for NSW first aiders to carry methoxyflurane (July 11, 2026) drew my attention to the fact that the Medicines, Poisons and Therapeutic Goods Act 2022 (NSW), along with the Medicines, Poisons and Therapeutic Goods Regulation 2026 (NSW) will come into effect on 5 November 2026 (see NSW Health, Medicine, Poisons and Therapeutic Goods legislation update, 3 July 2026).
I won’t go through the legislation in detail, but it does appear to have some very important changes for paramedics and first aiders.
Within this legislation there are provisions about the supply of scheduled drugs and their administration, but not about possession. A pharmacist must not supply a drug to a person who is not authorised under the Act or its regulations (Medicines, Poisons and Therapeutic Goods Act 2022 (NSW) s 28), and a person without authority must not administer the drugs (Medicines, Poisons and Therapeutic Goods Regulation 2026 (NSW) r 60); but there is nothing in the Act to say it is an offence to be in possession of scheduled drugs. I suspect that is a gap that if it is picked up will be picked up by the Drugs, Misuse and Trafficking Act 1985 (NSW) but I’m not in a position to explore the in’s and out’s of that Act in part because I cannot identify the drugs listed in sch 1 to that Act.
Under the new Medicines, Poisons and Therapeutic Goods legislation there are two issues, who is allowed to ‘buy’ the drugs and can they buy them from a pharmacist or do they need to buy from a wholesaler? And who can administer the drugs?
Paramedics
For paramedics the new regulation 68 says:
A member of staff of, or a volunteer engaged by, the Ambulance Service of NSW is authorised to administer a Schedule 2, 3, 4 or 8 substance to a person in accordance with the approved paramedic protocol.
That’s pretty straightforward, but only applies to those engaged by the Ambulance Service.
Regulation 69 says
A paramedic is authorised to administer a Schedule 2, 3, 4 or 8 substance to a person if the paramedic is a member of staff of a business, other than the Ambulance Service of NSW, that provides paramedical services or ambulance transport services in New South Wales or another state or territory.
That is a new regulation and makes it clear that interstate ambulance officers can administer the drugs as can employees of other paramedic and ambulance services.
The new regulation contains many references to a ‘health practitioner’ which is a term defined by the Health Practitioner Regulation National Law (NSW) (see the Medicines, Poisons and Therapeutic Goods Act 2022 (NSW) sch 3 definition of ‘health practitioner’) and includes a registered paramedic (Health Practitioner Regulation National Law (NSW) s 5 definition of ‘health practitioner’ and ‘health profession’).
Regulation 20 provides that any health practitioner may obtain ‘adrenaline for the treatment of anaphylaxis’. Any ‘health practitioner’ is authorised to administer a ‘Schedule 2 or 3 substance to a person’ in the course of their professional practice’.
With respect to vaccinations
A registered health practitioner is authorised to administer a vaccine to a person without a prescription if the practitioner—
(a) has an authority to administer the vaccine granted by the Health Secretary under section 74, and
(b) administers the vaccine in compliance with the approved standards.
That will widen the scope and make it easier for paramedics to get an authority, as the previous regulations referred to nurses, but the possibility is now extended to all health practitioners.
First Aiders
Regulation 15 says that a pharmacist may supply adrenaline, glucagon, glyceryl trinitrate, naloxone, salbutamol or terbutaline to a first aider with either ‘a current statement of attainment, issued by a registered training organisation, demonstrating competency in the use and administration, including access and preparation, of the substance for first aid’ or a current certificate issued by ‘an approved person’.
The same people may also obtain by wholesale the same drugs and methoxyflurane (r 22) although the use of methoxyflurane appears to be limited to Mines Rescue, a school principal and Surf Life Saving NSW (r 21).
Regulation 66 says:
(1) A first aider or other person giving first aid to a person is authorised to administer a Schedule 2 or 3 substance to the person.
(2) A first aider giving first aid to a person is authorised to administer a Schedule 4 substance to the person.
(3) A first aider is authorised under subsection (2) only if the first aider holds a current statement of attainment, issued by a registered training organisation, demonstrating competency in the use and administration, including access and preparation, of the substance for first aid.
Taken together r 15 and 66 says that a first aider who has completed the relevant training can buy Adrenaline, glucagon, glyceryl trinitrate, naloxone, salbutamol or terbutaline and anyone can administer those drugs to a person who needs then.
Only a first aider can give a schedule 4 drug and only if they have an appropriate certificate of attainment.
So here’s the catch – who is a first aider? Schedule 4 contains the dictionary that defines terms in the regulation. First aid means ‘immediate, acute treatment or care of a person who is suffering an illness or injury’. First aider means
‘… a person who—
(a) is a worker within the meaning of the Work Health and Safety Act 2011, and
(b) has been appointed by the person for whom they work to provide first aid.
That is a workplace first aider, not just someone who has completed a first aid course. Arguably it could also include a volunteer for a first aid organisation such as St John Ambulance as they are a ‘worker’ (as that term includes volunteers) and their role is to provide first aid – but it is probably intended to only apply to appointed workplace first aiders (Work Health and Safety Regulation 2025 (NSW) r 42(2)).
It follows that it is still the case that a person who is not a first aider (as defined) cannot buy schedule 2 and 3 drugs to put in their first aid kit ‘just in case’ though any offence would be committed by the pharmacist for supplying the drugs, not the person buying them (see s 28).
Conclusion
The Act is complex and requires a much more detailed knowledge of pharmacology than I have.
I would infer that for most people the situation is going to remain that an employer will obtain approvals to obtain by wholesale supply scheduled drugs in accordance with an approval issued by the Secretary of Health (the Medicines, Poisons and Therapeutic Goods Act 2022 (NSW) Chapter 3) and will in turn authorise employed staff.
The authority of paramedics and first aiders to administer sch 2, 3, 4, and in the case of paramedics sch 8 drugs, will be clearer but it still doesn’t allow them to go and buy schedule 4 and 8 drugs without further authority. A pharmacist can sell adrenaline and salbutamol to a ‘first aider’ to put in their first aid kit but it remains to be seen how the definition of ‘first aider’ is read. It does not mean anyone who has done a first aid certificate, but it might extend to volunteers within a first aid organisation.
This blog is a general discussion of legal principles only. It is not legal advice. Do not rely on the information here to make decisions regarding your legal position or to make decisions that affect your legal rights or responsibilities. For advice on your particular circumstances always consult an admitted legal practitioner in your state or territory.