Opioid pharmacotherapy in the community
Opioids are drugs that act on opioid receptors in the brain. They can be produced from the opium poppy or synthetically manufactured. These types of drugs are very strong pain relievers.
Opioids, such as oxycodone, morphine, fentanyl and tapentadol, are prescribed for pain management. These can still lead to dependency, especially when more than the prescribed amount is used.
Heroin is a highly addictive, illegal opioid.
Opioids can be prescribed to treat drug dependency.
Opioid substitution treatments
Opioid substitution treatments are replacement treatments used to reduce the demand for drugs such as heroin and
other opioids.
The goal of replacement treatment is to stabilise the lives of people experiencing drug
dependency, reduce their drug use, the harm associated with it, and the crime often related to it.
The medications available are:
Methadone
Methadone is a synthetic (artificially manufactured) opioid.
When used as an opioid pharmacotherapy, it is used as an oral medication and, unlike heroin and other opioids, the effects last up to 24 hours.
There are 2 methadone products available in Australia for daily opioid substitution therapy (OST):
- Methadone Syrup® 5mg/mL
- Biodone Forte Solution® 5mg/mL.
Buprenorphine
Buprenorphine is a synthetic opioid. It works by diminishing cravings for heroin and other opioids. It also prevents
or alleviates symptoms of withdrawal in people experiencing opioid dependency.
There are 4 buprenorphine products available in Australia for use in opioid substitution therapy (OST):
- Suboxone® sublingual film, which contain buprenorphine hydrochloride in strengths of 2mg and 8mg.
Suboxone® products also contain naloxone hydrochloride.
- Subutex® sublingual tablets, which contain buprenorphine hydrochloride in strengths of 0.4mg, 2mg or 8mg
- Sublocade® injection, which contains buprenorphine in a long-acting formulation (also called a
depot injection). Sublocade® comes in 2 dose strengths: 100 mg/0.5 mL and 300 mg/1.5 mL.
- Buvidal® injection, which contains buprenorphine in a long-acting formulation (also called a
depot injection). Buvidal Weekly® is available in 4 strengths: 8 mg, 16 mg, 24 mg and 32 mg.
Buvidal Monthly® is available in 4 strengths: 64 mg, 96 mg, 128 mg and 160mg.
Sublingual means the medicine is taken by dissolving it under the tongue.
Buprenorphine depot injections are administered to clients by their health professional, either weekly or
monthly.
Community Program for Opioid Pharmacotherapy (CPOP)
The Community Program for Opioid Pharmacotherapy (CPOP) provides replacement treatment for opioid dependence,
including heroin dependence and dependence from use of prescription opioids.
If you are treated with methadone, Suboxone® or Subutex®, you are expected to attend a nominated
pharmacy, either daily or every second day, to receive a supervised dose of opioid pharmacotherapy which your doctor
has prescribed.
When you have been in treatment for more than 6 months and are considered stable, the pharmacist may be able to
dispense you with a dose which can be taken home. This is called a 'takeaway' dose and can only be given to you the
day before the due dose.
If you are treated with Sublocade® or Buvidal®, your doses will be administered to
you by subcutaneous injection by a health professional, such as a doctor or nurse.
CPOP is a partnership between government and community service providers. The program has a shared care approach with
most opioid substitution treatment being provided by GPs and community pharmacists.
Accessing treatment in the CPOP
Initial contact with CPOP can be made by contacting:
How do I find an authorised CPOP doctor in my area?
To find an authorised CPOP prescriber, contact Community Pharmacotherapy Program (CPP) on 9219 1907.
How do I find a new dosing pharmacy?
The Community Pharmacotherapy Program (external site) will be able to assist with names of pharmacies who are participating in the CPOP who are able to take on a new patient.
The program can be contacted on 9219 1907.
What is a Drug Dependent Person?
You can be recorded as a Drug Dependent Person in two ways:
- A medical practitioner may notify the Department of Health if they become aware or suspect that you are
experiencing drug dependency.
- To receive treatment for drug dependence in the Community Program for Opioid Pharmacotherapy (CPOP), you need to
sign a statement. This statement acknowledges you are aware you will be recorded as a Drug Dependent Person.
Being recorded as a Drug Dependent Person means your doctor will need to apply to the Department of Health before
prescribing a Schedule 8 medicine (strong pain medicine, stimulant or medicinal cannabis) for you.
Being recorded as a Drug Dependent Person does not stop a health professional administering a Schedule 8 medicine to
you in an emergency (such as in hospital).
Further information is available here: Drugs of dependence
(healthywa.wa.gov.au)
Contact
Medicines and Poisons Regulation Branch
Mailing address: PO Box 8172, Perth Business Centre, WA 6849
Phone: 9222 6883
Email: MPRB@health.wa.gov.au
Acknowledgements
Medicines and Poisons Regulation Branch
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.