Pharmacotherapy, also known as Opioid Dependence Treatment (ODT) 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 minimise and manage an individual’s symptoms of craving and withdrawal, fostering a level of physical and mental stability upon which further support structures may be established.
Opioid Use Disorder (also commonly known to as opioid dependence) is a chronic, relapsing condition. While it can be perceived as being an issue only related to street drugs such as heroin, the misuse of pharmaceutical (i.e. prescribed) opioids has been growing steadily over the last two decades.
ODT medicines have recently (since July 2023) been included on the PBS, significantly lowering the barrier to access for patients. Given the expected increase in demand for treatment, now is an excellent time for health professionals to improve their knowledge of, and their confidence in this treatment space
Opioid pharmacotherapy in Victoria
In Victoria, pharmacotherapy is prescribed in the community by accredited GPs or nurse practitioners and is most commonly 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.
The policy changes rolled out in July 2023 have facilitated pharmacist administration of long-acting injectable buprenorphine, a newer formulation of Opioid Dependence Treatment which has seen a
significant growth in use since 2020.
Changes to Opioid Dependence Treatment (ODT) - July 2023
Since 1 July 2023, all ODT medicines have been listed on the Pharmaceutical Benefits Scheme, an exciting change which finally brought a degree of equity to this often-stigmatised area of medical treatment. Where previously patients had paid service fees upwards of $30 per week, now only a monthly co-payment is required, equal to that paid for any other medication on the PBS. The pharmacy claims a service fee retrospectively through the Pharmacy Program Administrator (PPA) portal.
Alongside this change, there has also been an increase of support for pharmacist-led administration of long-acting injectable buprenorphine (LAIB). Patients can access this service for free, with the pharmacist claiming through the PPA portal.
Many clinics which have an established LAIB program have been ordering the injections directly from the wholesaler. This arrangement may continue until 30 June 2024 (previously 30 November 2023), after which clinics will have to partner with a local pharmacy should they wish to continue offering this service as they had previously.
Should you encounter any difficulties in accessing or offering services as a result of these changes, we encourage you to contact the Area 4 Pharmacotherapy Network at A4PN@semphn.org.au or reach out to our support team:
- For prescribers: Dr Vivian Praeger - 03 8514 6680 (mobile divert)
- For pharmacists: Adrian May – 0420 970 942
The Pharmacotherapy Area-Based Networks (PABN) are a Victorian Government initiative to provide opioid pharmacotherapy support for primary care medical and nurse practitioners, nurses, pharmacists and other clinicians, across the state of Victoria including metropolitan, regional and rural areas.
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