Putting an asthma puffer or epipen in your first aid kit

I have made the point in earlier posts that scheduled drugs should not be carried in first aid kits without relevant authority (see for example Taking drugs out of their box to save space (November 6, 2024) and The last word on scheduled drugs? (September 29, 2019)).

Two schedule 3 drugs that are relevant to first aid are salbutamol in puffers for use in treating asthma and adrenaline in auto-injectors for treating anaphylaxis.  Can you carry these drugs in your first aid kit without first applying for and receiving special authority?¹

	Salbutamol puffers	Adrenaline autoinjector
ACT	Yes, it is only an offence to obtain or possess sch 3 drugs that are listed in the regulations (Medicines, Poisons and Therapeutic Goods Act 2008 (ACT) s 36) but none are listed. Anyone may supply and administer ‘salbutamol in, or for, a metered inhaler’ to anyone ‘who is in immediate need of … salbutamol’; Medicines, Poisons and Therapeutic Goods Regulation 2008 (ACT) r 410.	Yes, it is only an offence to obtain or possess sch 3 drugs that are listed in the regulations (Medicines, Poisons and Therapeutic Goods Act 2008 (ACT) s 36) but none are listed. Anyone may supply and administer ‘adrenaline in a single use automatic injector delivering not more than 0.3mg adrenaline’ to anyone ‘who is in immediate need of adrenaline …’; Medicines, Poisons and Therapeutic Goods Regulation 2008 (ACT) r 410.
NSW	A person who holds a current emergency asthma management certificate issued by an organisation approved by the Secretary of Health is authorised to possess and use salbutamol or terbutaline in metered aerosols if required in connection with the carrying out of first aid; Poisons and Therapeutic Goods Regulation 2008 (NSW) Appendix C cl 12.	A person is authorised to possess and use adrenaline for anaphylaxis first aid provided the adrenaline is contained in single use automatic injectors that have been filled by the manufacturer and that deliver no more than 0.3 milligrams of adrenaline each, and the person holds a current first aid certificate issued after completion of a first aid course approved by the WorkCover Authority as referred to in regulations made under the Occupational Health and Safety Act 2000, and the person has received training on the symptoms and first aid management of anaphylaxis from— (i)  a first aid training organisation approved by the WorkCover Authority, or (ii)  any other organisation approved by the Secretary; Poisons and Therapeutic Goods Regulation 2008 (NSW) Appendix C cl 13.2
NT	No; Medicines, Poisons and Therapeutic Goods Act 2012 (NT) ss 37 and 38.	No; Medicines, Poisons and Therapeutic Goods Act 2012 (NT) ss 37 and 38.
Qld	A person who has a current certificate granted by a registered training organisation for the provision of first aid and who has completed asthma training; Medicines and Poisons (Medicines) Regulation 2021 (Qld) sch 5, part 2.	A person who has a current certificate granted by a registered training organisation for the provision of first aid and who has completed anaphylaxis training; Medicines and Poisons (Medicines) Regulation 2021 (Qld) sch 5, part 2.
SA	No; Controlled Substances Act 1984 (SA) s 15 and Controlled Substances (Poisons) Regulations 2011 (SA) r 12.	No; Controlled Substances Act 1984 (SA) s 15 and Controlled Substances (Poisons) Regulations 2011 (SA) r 12.
Tas	No, but provision is made for a First Aid Providers Licence to be issued to a first aid provider service (not an individual) to allow the use of salbutamol and other drugs; Poisons Act 1971 (Tas) r 18A and Poisons Regulations 2018 (Tas) r 10.	No, but provision is made for a First Aid Providers Licence to be issued to a first aid provider service (not an individual) to allow the use of salbutamol and other drugs; Poisons Act 1971 (Tas) r 18A and Poisons Regulations 2018 (Tas) r 10.
Vic	No, but may be obtained and used by the holder of a first aid service licence; Drugs, Poisons and Controlled Substances Regulations 2017 (Vic) rr 133E and 141.	No, but may be obtained and used by the holder of a first aid service licence; Drugs, Poisons and Controlled Substances Regulations 2017 (Vic) rr 133E and 141.
WA	No; Medicines and Poisons Act 2014 (WA) s 13.3	No; Medicines and Poisons Act 2014 (WA) s 13.3

NOTES

1. This table is about buying these schedule 3 drugs to include in a private first aid kit where the drugs have not been purchased for the benefit of the person buying them or someone they are caring for (eg their child).  It does not address, or identify, people who have permission because of the nature of their employment or volunteer role eg teachers, child-care workers, ski patrollers etc to have these drugs as part of their workplace first aid kit. Where this type of authority is granted, it relates to their role and does not allow them to carry the drugs in their private kit.   Further, this table does not address assisting a person to use their own puffer or epipen or using a puffer or epipen that someone else lawfully possesses to benefit someone else in the event of a medical emergency. For the purpose of this table I have in mind someone who wants to buy an epipen or asthma puffer to put in their own kit, ‘just in case’.
   
   Where the legislation provides explicit permission (NSW and Qld) those sections are cited. In many other cases it is a negative inference, that is there are provisions that allow specifically listed people eg health practitioners or holders of first aid kit licences to carry these drugs. The inference is if anyone could possess them for first aid use, these specific authorities would not be required. I have therefore cited sections that identify where a class of persons are authorised to carry these drugs with the inference that a first aid qualified citizen, given they are not listed, is not permitted to carry them.  For example, if provision is made for ‘first aid licences’ to authorise the possession and use of the drugs, it follows that someone without that licence cannot put them in their first aid kit.
   
   
2. The NSW legislation is clearly out of date.   The Occupational Health and Safety Act 2000 (NSW) was repealed and replaced by the Work Health and Safety Act 2011 (NSW) in 1 January 2012.  The WorkCover Authority was replaced by SafeWork NSW on 1 September 2015.
   
3. In WA it is arguable. To supply includes to have ‘possession of the poison for the purpose of supplying it’ (s 8(2)(c)) but supply ‘does not include administering a poison or substance directly to another person’ (s 8(1)). Any person may supply a sch 3 drug to a person who has a therapeutic need for the drug (s 13(2)). If, therefore you have the drug lawfully in your posession you can give it to someone who needs it, but the issue is whether buying it to have it in your kit is ‘possession for the purpose of supply’ (given at that point you do not have any person with a thereapeutic need identified). If it is then that is unlawful. If it is not then there is no offence.
   
   Further the Act allows health practtitioners to possess and supply drugs (s 25). The definition of heatlh professional includes ‘first aid providers (vessels)’ and ‘medics’ (Medicines and Poisons Regulations 2016 (WA) r 38). ‘First aid providers (vessels)’ are specifically authorised to supply a schedule 3 poison (r 49(2)) (and see s 62B for the same authority for medics; s 62 for paramedics etc). If the arguments, above, relating to sch 3 drugs meant that they can carry those drugs without specific authority those sections would have no work to do. Whilst it is arguable I think it is not lawful (s 13) to have these drugs for the purpose of supplying them in circumstances where there is no person with an identified therapeutic need, ie to carry them in a first aid kit ‘just in case’.

POSTSCRIPT

After writing this post, Matt Wilkinson-Stokes, a PhD student in the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne drew my attention to a ‘Scope of Practice Review’ conducted by the Federal Government.  You can access a copy of the report here: https://www.health.gov.au/sites/default/files/2024-04/unleashing-the-potential-of-our-health-workforce-scope-of-practice-review-issues-paper-2_0.docx.

Of relevance to this discussion is the information from p. 95 to p. 113 on drug regulation in each state and territory.  These tables show the complexity and inconsistency across the jurisdictions (even though they are trying to implement a national plan).   They also confirm that the use of all scheduled drugs, including schedule 2 and 3 drugs is restricted.   These tables are dealing with the authority of health practitioners to possess, supply, administer, prescribe or otherwise deal with scheduled drugs but it stands to reason that if these practitioner require specific authority to use sch 2 and 3 drugs, it cannot be the case that anyone can buy these drugs from a pharmacist and then carry them in order to supply them to anyone that they think needs them without specific authority.

There is authority to buy, possess and supply or administer these drugs if a person has a clinical need or is caring for someone with a clinical need.  And as I’ve identified there is specific authority in the ACT, NSW and Queensland.  There are also authorities for various office holders, employees and volunteers to have these drugs across the jurisdiction.  But as a general rule, you cannot carry schedule 2 and 3 drugs in your first aid kit for the purpose of supplying those drugs to someone you have not yet met but in circumstances where you will decide they need them.   These drugs are available for supply to the public by a pharmacist, not by a person who bought the drugs from a pharmacist.

This blog is made possible with generous financial support from (in alphabetical order) the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), the Australian Paramedics Association (Qld), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.

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.