Pharmacotherapy for opioid dependence

Safer treatment and better recovery from opioid dependance

Pharmacotherapy, also known as Opioid Replacement Therapy (ORT) or Medication Assisted Treatment of Opioid Dependence (MATOD) is an effective, evidenced-based approach to treating patients with Opioid Use Disorder. Pharmacotherapy involves the use of methadone, buprenorphine or buprenorphine/naloxone to help control an individual’s craving and withdrawal, providing a level of stability upon which further support structures may be established.

Opioid Use Disorder (commonly referred to as opioid dependence) is a chronic, relapsing condition, which affects people from all walks of life. While it is commonly perceived as being an issue related to street drugs such as heroin, the misuse of pharmaceutical (i.e. prescribed) opioids has been growing steadily over the last two decades.

With SafeScript now live, more patients may be identified as having a dependence on opioids. Now more than ever it is important for health professionals to be confident in this treatment space in order to make safe and appropriate clinical decisions.

Victorian Area-Based Pharmacotherapy Networks

Three Victorian Area-Based Pharmacotherapy Networks were established to increase the uptake of pharmacotherapy service provision by general practices and community pharmacies. This is achieved through:

  • Provision of GP mentor and Addiction Medicine Specialist supports
  • Community of Practice education events
  • Small Group Learning education events
  • Facilitation of access to pharmacotherapy training for:
    • GPs and nurse practitioners
    • Pharmacists
    • Practice Managers

For more information about the services available in your region, please contact:

Area 4 Pharmacotherapy Support (Eastern region)

Adrian May

Email: adrian.may@semphn.org.au

Phone: 0429 808 317

Area 5 Pharmacotherapy Support (Northern region)

Andrea Calleja

Email: pharmacotherapy@cohealth.org.au

Phone: 0439 436 772

Area 3 – Hume Pharmacotherapy Network (Mitchell & Murrindindi)

Tim Griffiths

Email: TGriffiths@primarycareconnect.com.au

Phone: 5823 3219

Pharmacotherapy service in general practice

In Victoria, pharmacotherapy is prescribed in the community by accredited GPs or nurse practitioners, and dispensed in approved community pharmacies. An increasing demand for treatment coupled with a decreasing number of pharmacotherapy prescribers has resulted in a gap in service provision in this sector.

In recognition of the safety and efficacy of buprenorphine/naloxone, the Victorian DHHS Policy for Maintenance Pharmacotherapy for Opioid Dependence changed in April 2020 to allow medical practitioners to prescribe buprenorphine/naloxone for up to 30 patients without undertaking the formal RACGP pharmacotherapy training. This is an important change to improve patient access to pharmacotherapy.

Free face-to-face support and education is available for prescribers managing opioid dependence (see below), as well as a 16-minute video and four-page guide, which can assist GPs with prescribing buprenorphine/naloxone.

GP support and education

RACGP Victoria delivers the approved training for Medication Assisted Treatment for Opioid Dependence (MATOD) prescribing. The aim of this workshop is to provide practitioners with the skills and confidence to assess, manage and initiate patients on Opioid Replacement Therapy.

Access the MATOD training information here.

Pharmacotherapy service in pharmacy

In Victoria, pharmacotherapy is a supervised dosing program with medication provided in the community pharmacy setting.

Pharmacies wishing to provide pharmacotherapy services are required to obtain approval from the Department of Health and Human Services by completing an application form which can be found here.

The Pharmaceutical Society of Australia (PSA) offers free training for pharmacists interested in the field of pharmacotherapy. The link to the registration page for this training may be found here.

The Pharmacotherapy Area-Based Networks (PABN) offer a variety of support for pharmacies managing patients with opioid dependence:

  • Advice about accredited training and obtaining approval to provide pharmacotherapy services
  • Advice about how to set up a new pharmacotherapy program
  • Education for pharmacists, including Small Group Learning meetings and Community of Practice events
  • Local ancillary services, such as Alcohol and other Drug and Mental Health services