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Opioid drugs

Opioids are chemical substances that have a morphine-type action in the body. They are most commonly used for pain relief, but they are addictive and can lead to drug dependence. They include:

  • opiates-drugs naturally derived from the opium poppy, such as codeine and heroin
  • semi-synthetic opiates, such as hydromorphone and oxycodone
  • opioids, such as fentanyl and methadone.

Opioid drugs can be:

  • illicit opioids, predominantly heroin (WHO 2013)
  • prescription opioids (whether prescribed for the person or obtained illicitly) such as morphine and oxycodone (Roxburgh et al. 2011)
  • over-the-counter opioids in which the opioid drug codeine is combined with a non‑opioid analgesic such as paracetamol or ibuprofen (Nielsen et al. 2010).

Opioid drug dependence

Dependence on opioid drugs such as heroin or morphine is associated with a range of health and social problems that affect individual drug users, their family and friends, and the wider public. Opioid dependence can lead to many problems such as overdose, medical and psychological complications, social and family disruption, harms to child welfare, violence and drug-related crime, and the spread of bloodborne diseases. It is considered a serious public health issue (WHO 2013).

Drug dependence is characterised by drug seeking and using, but people experience it in various ways. The International statistical classification of diseases and related health problems, 10th revision (ICD-10) (WHO 2010) defines 'dependence syndrome' due to the use of opioids as:

'A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state (Code F11.2).'

In 2013, it was estimated that about 3% of Australians had used opioids for non‑medical reasons over their lifetime, while 1.2% had used heroin. Among those Australian seeking treatment for drug and alcohol problems in 2013-14, opioids were a drug of concern in about 1 in 9 (11%) treatment episodes.

Opioid pharmacotherapy treatment

Opioid pharmacotherapy treatment is one of the main treatment types used for opioid drug dependence and involves replacing the opioid drug of dependence with a legally obtained, longer-lasting opioid that is taken orally.

In Australia, 3 medications are registered for long-term maintenance treatment for opioid-dependent people:

  • methadone
  • buprenorphine
  • buprenorphine-naloxone.

These drugs, known as opioid pharmacotherapies, reduce withdrawal symptoms, the desire to take opioids, and the euphoric effect of taking opioids. Treatment with these drugs is administered according to the law of the relevant state or territory, and within a framework which includes medical, social and psychological treatment.

The Australian Government Department of Health, as part of the National Drug Strategy, published the National guidelines for medication-assisted treatment of opioid dependence (DoH 2014) to provide a broad policy context and framework for state and territory policies and guidelines that are concerned with the medication-assisted treatment of opioid dependence.

The NOPSAD collection

The National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection is a set of jurisdictional data that includes information about:

  • clients accessing pharmacotherapy for the treatment of opioid dependence;
  • prescribers participating in the delivery of pharmacotherapy treatment; and
  • dosing sites providing pharmacotherapy drugs to clients.

For more information see: