Department of Health

Pharmacotherapy – forms, applications and pharmacotherapy networks

Forms and applications

There are several types of forms to submit if you are an approved pharmacotherapy prescriber or pharmacy.

Permission to treat an opioid-dependent person

Approved medical practitioners or nurse practitioners need to apply for a permit to treat an opioid-dependent person with methadone or buprenorphine by submitting the following application form at Online forms – drugs and poisons regulation.

Approval for pharmacotherapy prescribing or supply

Medical practitioners, nurse practitioners and community pharmacies may use the following forms to become a pharmacotherapy prescriber or supplier:

Pharmacotherapy pharmacists – self-assessment

The following form helps pharmacists to assess their compliance with key regulatory and policy requirements associated with the safe, appropriate and lawful provision of opioid replacement therapy (ORT).

Note that the form does not address all aspects of the requirements. Pharmacists should refer to the following documents for full details:

Prescribing and dispensing Suboxone®

Suboxone is a sublingual film that contains the active ingredients buprenorphine and naloxone. It is registered with the Therapeutic Goods Administration for use in Australia for the treatment of opioid dependence through the Section 100 Opiate Dependence Treatment Program.

It is fully subsidised by the Commonwealth government under the Pharmaceutical Benefits Scheme for opioid replacement therapy.

There has been some confusion about the legality and practicalities of prescribing and dispensing Suboxone for purposes other than opioid replacement therapy (off-label use).

For further information download the Suboxone® factsheet.

Victorian Pharmacotherapy Area-Based Networks

The Victorian opioid pharmacotherapy system is a community-based model, where medical practitioners, nurse practitioners and pharmacists work together to treat people with opioid dependence in the community.

Five Pharmacotherapy Area-Based Networks (PABNs) operate in Victoria to facilitate local approaches in connecting care, driving best practice and improving health and wellbeing outcomes for people experiencing opioid dependence.

Each PABN supports health professionals (general practitioners, nurse practitioners, pharmacists and allied health clinicians) to identify and treat opioid dependence throughout the state.

PABNs identify and support local solutions to service need in their catchment area, work with other services to form partnerships and referral pathways, facilitate ongoing training for providers and provide access to addiction medicine specialist support.

Contacts

Area 1: Barwon South West Pharmacotherapy Network

Phone: 03 5222 0800

Email: pharmacotherapy@westvicphn.com.au

Area 2: ORTicare Grampians and Loddon Mallee Pharmacotherapy Network

Phone: 03 5338 4500 or 5338 9142

Email: orticare@bchc.org.au

Area 3: Gippsland and Hume Pharmacotherapy Network

Gippsland Pharmacotherapy Network

Phone: 1800 242 696

Email: pharmacotherapy@lchs.com.au

Hume Pharmacotherapy Network

Phone: 03 5823 3200

Email: PABN@primarycareconnect.com.au

Area 4: South and Eastern Metropolitan Pharmacotherapy Network

Phone: 03 8514 6600 

Email: A4PN@semphn.org.au

Area 5: North and West Metropolitan Pharmacotherapy Network

Phone: 03 9448 5530

Email: pharmacotherapy@cohealth.org.au

Reviewed 13 May 2025

Health.vic

Contact details

Postal address: Medicines and Poisons Regulation Department of Health GPO Box 4057 Melbourne VIC 3001

Medicines and Poisons Regulation Department of Health

Was this page helpful?