Key messages
- Pharmacotherapy is an effective treatment for opioid dependence.
- The department has developed a policy for prescribers and pharmacists to help them make safe, effective and legal decisions about treating patients on pharmacotherapy.
- The latest update to this policy takes effect from 1 July 2023 and reflect changes made to the Pharmaceutical Benefits Scheme (PBS), which introduced additional prescribing requirements and new patient-fee arrangements.
- All other elements of the policy remain as per the last substantive revision in 2016.
Pharmacotherapy, or opioid replacement therapy (ORT) is an effective treatment for opioid dependence.
Pharmacotherapy can be used for several types of patients:
- those who have used heroin for a long time
- those experiencing problematic use of prescription opioids and over-the-counter codeine-containing analgesics.
Studies have shown that many people who stop using opioids will relapse and start using illicit opioids. Maintenance pharmacotherapies can prove valuable in assisting these people to successfully manage physical dependence, drug craving and compulsive drug use.
Methadone and buprenorphine have been used to treat opioid dependence, both in detoxification from opioids and maintenance treatment.
Revised Policy for maintenance pharmacotherapy for opioid dependence
Victoria's current Policy for maintenance pharmacotherapy for opioid dependence has been revised and is effective from 1 September 2016.
The latest update to policy and information takes effect from 1 July 2023 and reflect changes made to the Pharmaceutical Benefits Scheme (PBS), which introduced:
- additional requirements for prescribing ORT
- the usual PBS co-payment for the supply of pharmacotherapies (usually for up to 28 days’ supply per pharmaceutical benefit prescribed), with the amount paid contributing towards the PBS Safety Net threshold
- importantly, from 1 July 2023, pharmacists cannot charge patients additional private dispensing or dosing fees for the supply of ORT under the PBS.
All other elements of the policy remain as per the last substantive revision in 2016.
There is significant focus in the revised Policy on pharmacotherapy take-away doses, which can be fatal if diverted, shared or ingested incorrectly.
Pharmacotherapy providers are encouraged read the revised policy and understand that the tightened guidelines deliver stronger, clearer, safer and additional advice on the provision of pharmacotherapies throughout Victoria.
Medication assisted treatment of opioid dependence (MATOD)
For guidance on medication assisted treatment of opioid dependence, see the following resources on the Health services and general practice - coronavirus disease (COVID-19) page of the Department of Health website.
Reviewed 23 October 2023