Opioid maintenance treatment
Opioid maintenance treatment (methadone, buprenorphine/naloxone, buprenorphine) aims to minimise the harms related to opioid use.
Methadone comes in the form of a syrup and is used to treat opioid dependent people. Buprenorphine/naloxone comes in a wafer that is dissolved in the mouth.
Starting opioid treatment
People wanting to start on opioid treatment are assessed to determine suitability for treatment. This involves taking a history and conducting a physical examination.
If suitable, an induction process will be started, usually on the day of assessment. Clients continue to be reviewed by members of the treating team while receiving opioid maintenance treatment.
The treating team enquires about drug use, health and other psychological and social factors, and will discuss other assessments as well, including screening for Blood Borne Virus’.
Prescriptions for opioid maintenance treatment are reviewed at least every three months.
In Australia, methadone, buprenorphine/naloxone and buprenorphine are only legal within a treatment program.
Specialist Medical Services
This service provides:
- Comprehensive client drug and alcohol management
- Induction and ongoing care for clients with complex needs who are prescribed Opiate Replacement Therapy (Pharmacotherapy)
- Medicated withdrawal (Inpatient and Outpatient)
- Referral for other medical services as appropriate
- Liaison and provisionof medical advice and care to inpatients at The Canberra Hospital and advice to GP's and health care practioners
- Education to other health care professionals and the general public
The Medical Service is a team of dedicated doctors who are experts in the field of alcohol and drug medicine. The Medical Service doctors accept referrals from GP's and other health professionals.
Methadone is a potent synthetic opioid agonist which is well absorbed orally and has a long, although variable plasma half life. The effects of methadone are qualitatively similar to morphine and other opioids.
Buprenorphine is a derivative of the morphine alkaloid, thebaine, and is a partial opioid agonist. Buprenorphine diminishes cravings for heroin, and prevents or alleviates opioid withdrawal in dependent heroin users.
Buprenorphine has a higher affinity for opioid receptors than full opioid agonists. Because of this, buprenorphine can block the effects of other opioid agonists in a dose dependent fashion. By its dual effects of reducing craving and reducing the response to administered heroin, buprenorphine reduces the self-administration of heroin.
All ACT medical practitioners with unconditional medical registration with the ACT Medical Registration Board are able to prescribe continuing opioid maintenance treatment for up to five stable clients. Clinical consultation/liaison advice is available to all medical practitioners (e.g. a general practitioner) from the medical specialists and other practitioners at the Alcohol and Drug Service (ADS).
Most clients will commence dosing at either a community pharmacy or ADS. The prescriber must confirm arrangements with the pharmacy that the client wishes to attend for supervised dosing. This confirmation will involve a client visit to the pharmacy to allow the client and pharmacist to agree on dosing arrangements.
Who can use this service?
People who have an opioid dependency are suitable to be assessed for opioid maintenance treatment.
How can I access it?
By contacting the 24 Hour Helpline (02) 6207 9977 for initial information and assessment, or by contacting your medical practitioner.
The National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection provides national data on clients being treated with medication (pharmacotherapy) for their dependence on opioid drugs such as heroin. It also provides statistics on those prescribing the medication and where it was dispensed. The latest bulletin may be sourced from the Australian Institute of Health and Welfare website (see AOD Links - National) and search for 'NOPSAD'.