National Opioid Pharmacotherapy Statistics Annual Data collection: 2009 report
Contents
Highlights
Background
Where does pharmacotherapy fit in alcohol and other drug treatment provision?
Development of the NOPSAD collection
What is the NOPSAD collection used for?
Scope of the NOPSAD collection
About pharmacotherapies
Overview of features of opioid pharmacotherapy systems
Terminology
Administrative features in each jurisdiction
Clients receiving pharmacotherapy treatment
Prescribers of pharmacotherapy drugs
Pharmacotherapy dosing point sites
Demographic profile of clients receiving pharmacotherapy treatment
Key new policy initiatives
Data custodianship
Related data collections
Appendix Tables
References
Acknowledgments
Highlights
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 data are based on a ‘snapshot’ period—usually a day—in June 2009. Snapshot data provide a glimpse of pharmacotherapy treatment activity on a specified day, but do not capture the total estimated activity for any given year. However, snapshot data are considered to be a good representation of the total client base.
This is the third bulletin featuring national data from the NOPSAD collection. The first bulletin was released in July 2007 (AIHW 2007). 
Main findings
•	At 30 June 2009, there were 43,445 pharmacotherapy clients. Of those clients, around two-thirds were male.
•	The number of clients in 2009 increased by 2,098 compared with 2008.
•	There was a proportional decrease amongst clients aged 29 years or younger and an increase amongst clients aged 40 years and over.
•	Seven out of ten clients (70%) were receiving methadone and the remainder received buprenorphine or buprenorphine/naloxone. This finding has remained stable since 2006.
•	The total number of prescribers nationally (1,350) has decreased slightly since 2008 (1,393).
•	The majority of pharmacotherapy clients (64%) received treatment from a private prescriber. 
•	The average number of clients per prescriber rose slightly between 2008 (30) and 2009 (32), however is now consistent with the average seen in 2005 (32).
•	The total number of dosing point sites (2,157) has seen a small increase since 2008 (2,143).
•	Most dosing point sites were located in pharmacies (85%). 
•	In 2009, 36% of pharmacies across Australia dosed pharmacotherapy clients.
•	The average number of clients per dosing point site has risen slightly between 2007 (18) and 2009 (20). 
Background
In Australia, people who are opioid dependent have had the option of opioid pharmacotherapy treatment for a number of decades (methadone since 1969 and buprenorphine since the 1980s). The Australian Government currently funds the provision of these pharmacotherapy drugs via pharmaceutical benefits arrangements, through clinics and pharmacies approved by state and territory governments. Pharmacotherapy treatment for opioid dependence is administered according to the law of the relevant state or territory, and within a framework which includes medical treatment, as well as social and psychological treatment. 
The National pharmacotherapy policy for people dependent on opioids (DoHA 2007) was released in January 2007 by the Australian Government Department of Health and Ageing (DoHA). This provides a broad policy context and a framework for state and territory policies and guidelines that are concerned with the treatment of opioid dependence using methadone, buprenorphine and buprenorphine-naloxone.
The broad goal of treatment for opioid dependence is to reduce the health, social and economic harms to individuals and the community arising from illicit opioid use (DoHA 2007). 
In 1985, methadone maintenance treatment was endorsed as Australian policy, and national information on the numbers of pharmacotherapy clients was first collated in 1986. 
Where does pharmacotherapy fit in alcohol and other drug treatment provision?
Pharmacotherapy is one treatment option available for people who are dependent on opioid drugs. Pharmacotherapy is also available for people who are dependent on other substances, for example alcohol or tobacco, however, this bulletin only includes those drugs used for opioid pharmacotherapy. Research evidence demonstrates that pharmacotherapy treatment for opioid dependence is successful for many individuals in reducing the harms associated with opioid dependence (see for example Ritter & Chalmers 2009). Some individuals will stay on opioid maintenance treatment for longer periods of time than others. Other approaches to the treatment of opioid dependence can include supervised detoxification followed by individually based treatment plans or strategies that are designed to support abstinence from opioid drugs. 
There is a range of alcohol and other drug treatment services in Australia which provides treatment for people who are dependent on opioids and or other drugs. Each treatment agency is different and depending on its size and philosophical approach to treatment, each provides a range of options in different settings. After assessment of individual needs, treatment providers and clients work together to plan a treatment strategy that suits the individual’s needs. In the case of opioid pharmacotherapy treatment, referral or partnerships between agencies, prescribers and dosing points can be beneficial as not every treatment agency or setting can provide assessment, prescription of pharmacotherapy drugs, dosing points, monitoring of medication and counselling or other treatment support. 
Development of the NOPSAD collection
In December 1999, the Commonwealth Government and state and territory governments, through the National Health Information Management Group, endorsed the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS–NMDS). A national minimum data set is a nationally accepted set of data elements mandated for collection. Collection of the AODTS–NMDS commenced on 1 July 2000. However, due to particular complexities in collecting information about pharmacotherapy provision for opioid dependence, agencies whose sole activity is to prescribe and/or dispense doses for opioid pharmacotherapy treatment are excluded from the scope of the collection. Instead, data on clients receiving opioid pharmacotherapy treatment are routinely collected by state and territory health departments. Up until 2005, data were provided each year to DoHA. In 2005, DoHA commissioned the Australian Institute of Health and Welfare (AIHW) to manage the collection, including the analysis and reporting of pharmacotherapy treatment data. A set of agreed standards for reporting were developed in consultation with states and territories, and the National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection was developed. While jurisdictions strive to report data consistent with agreed standards, the NOPSAD collection is not a national minimum data set and some discrepancies exist between the ways data are reported.

What is the NOPSAD collection used for?
The main purpose of the current NOPSAD collection is to bring together jurisdictional data in a standardised form on clients accessing pharmacotherapy for the treatment of opioid dependence, information on prescribers participating in the delivery of pharmacotherapy treatment, and quantitative information about the prescribing sector.
The NOPSAD collection is one of a number of data sources that provide a picture of alcohol and other drug treatment services in Australia. Data from the collection can also be considered along with information from other sources (for instance, the AODTS–NMDS and the National Drug Strategy Household Survey) to inform debate, policy decisions and planning processes that occur within the broader alcohol and other drug treatment sector. More specifically, pharmacotherapy data are used in states and territories to:
•	monitor resources required for pharmacotherapy treatment, such as the number of prescribers and dosing point sites
•	monitor and plan services (e.g. monitoring prescriber patterns and capping the number of clients)
•	develop and refine policies relating to treatment of clients with opioid dependency
•	track the number of clients moving between the public and private sectors.
Data are also used more broadly to fill gaps in national treatment services data. 
Scope of the NOPSAD collection
The collection covers the provision of opioid pharmacotherapy treatment, the practitioners who prescribe treatment, the dosing sites where pharmacotherapy drugs are dispensed, and the clients receiving opioid pharmacotherapy treatment.  
Methadone clinics (private or public) and approved pharmacies can dispense methadone, buprenorphine and buprenorphine/naloxone. At commencement of treatment, clients need to attend the clinic or pharmacy to take their dose under supervision (Pharmaceutical Society of Australia 2005). In certain circumstances, clients may be eligible to receive a takeaway dose. The takeaway dose for methadone is determined by each jurisdiction in line with the National Policy on Methadone Treatment (DoHA 2003). The policy for unsupervised dosing of buprenorphine and buprenorphine/naloxone is determined by each Australian jurisdiction. Prescribers are required to check with the relevant authority in their jurisdiction to determine if there is a preference as to which formulation of buprenorphine is used for unsupervised dosing (Lintzeris et al. 2006).
About pharmacotherapies
The following pharmacotherapies are currently recommended for the treatment of opioid dependency (DoHA 2008):
•	methadone hydrochloride—Methadone Syrup®, Biodone Forte®
•	buprenorphine—Subutex®
•	buprenorphine/naloxone—Suboxone®.
Methadone, buprenorphine and buprenorphine/naloxone can be used as short-term or long-term detoxification medications or indefinitely as maintenance medications (see Box 1 for clinical descriptions). Maintenance programs allow clients to stay on these substances indefinitely, and provide clients with an alternative to using illicit drugs.
Box 1: Pharmacotherapy—clinical descriptions
Methadone
Methadone is a synthetic opioid agonist used mainly for maintenance therapy although it may be used as a withdrawal agent for those dependent on opioids. It reduces the use of heroin through cross-tolerance, which results in a reduction of heroin withdrawal symptoms, less desire to use heroin, and reduced euphoric effect when heroin is used. Methadone is taken orally on a daily basis (DoHA 2007).

Buprenorphine
Buprenorphine is often called a partial opioid agonist with high receptor affinity. It has actions similar to the full agonist drugs but with less efficacy, so that increases in dose have progressively less effect. Two buprenorphine products are currently registered in Australia for the treatment of opioid dependence within a framework of medical, social and psychological treatment: the mono product (Subutex®) is a sublingual tablet containing buprenorphine hydrochloride in 0.4, 2.0 and 8.0 mg strengths; the combination product (Suboxone®) is a sublingual tablet containing buprenorphine hydrochloride and naloxone hydrochloride in a ratio of 4:1. Suboxone® is available in two dosage strengths—2.0 mg buprenorphine and 0.5 mg naloxone, and 8.0 mg buprenorphine and 2.0 mg naloxone. The properties of buprenorphine and naloxone are such that, when taken sublingually, Suboxone® will act as if it was buprenorphine alone. However, if the combined preparation is injected, the naloxone will have a clinically significant effect, so that it is likely to attenuate the effects of the buprenorphine in the short term, and is also likely to precipitate withdrawal symptoms in opioid-dependent individuals using heroin or methadone (DoHA 2007).
Overview of features of opioid pharmacotherapy systems
Prescriber authorisation and training
Each jurisdiction has rules about how doctors are authorised to prescribe methadone and buprenorphine. Most jurisdictions require doctors to undertake accredited training. In some jurisdictions, such as New South Wales and the Australian Capital Territory, doctors can be authorised to prescribe to up to five clients without attending a training course first. In the Australian Capital Territory, this authorisation is for clients that are receiving ongoing treatment only; clients must be inducted to treatment by doctors that have received specialised training.
The prescribers who are registered may or may not be active. Some jurisdictions such as New South Wales and South Australia only report on prescribers who are active, that is prescribers who are scripting at least one client as at 30 June 2009.
When methadone was the primary pharmacotherapy drug used for opioid treatment, prescriber training focused on this drug alone. In most cases the registration process is now updated to include new pharmacotherapies that are approved for prescription (e.g. buprenorphine/naloxone).  For various reasons some prescribers are only authorised to prescribe buprenorphine. In Tasmania, training is provided separately for each pharmacotherapy drug.
In Victoria, all general practitioner (GP) registrars are offered pharmacotherapy training. In New South Wales, all psychiatric registrars undergo a pharmacotherapy training component and in turn become authorised/registered. They may however, never become active prescribers. 
Number of clients per prescriber
In all states and territories a cap on the number of pharmacotherapy clients per prescriber is stated as a guide. This cap is not usually included in legislation. Exceptions can be made to the cap to accommodate clients. In particular a prescriber’s cap may be extended if someone being released from prison needs to find a prescriber in their local area to continue to receive pharmacotherapy. 
Cost to clients
Depending on the jurisdiction and the dosing point type, opioid pharmacotherapy can be free or there can be a charge for dosing at a pharmacy. Such cost to clients may limit people’s access to opioid pharmacotherapy (Ritter & Chalmers 2009). 
The Pharmaceutical Benefits Scheme (PBS) does not provide a subsidy to community pharmacists for dosing, therefore there is a cost to the client if they are dosed at a community pharmacy. Dosing at public clinics is free. In some jurisdictions this means that those who have places at a public clinic may be reluctant to move to a community pharmacy dosing point as this will mean they incur extra cost. In the Australian Capital Territory, all clients receiving opioid maintenance treatment are expected to pay a fee. ACT Health offers a subsidy to community pharmacies for clients on opioid maintenance treatment. The fee is waived for clients dosing at ACT Health’s Alcohol and Drug Program clinic for the first three months. A further exemption may be provided to extend the waiver for priority populations.
One limitation for opioid pharmacotherapy clients is that in many cases they have to travel each day to their dosing point. To overcome this daily travel there is provision for takeaway doses in some circumstances. Policies on takeaway dosing vary by jurisdiction. For example, in the Australian Capital Territory there is a provision for clients who have demonstrated stability on methadone treatment to be given takeaway doses. There is also a provision in the Australian Capital Territory for clients on buprenorphine to be granted takeaway doses although the buprenorphine mono product is only approved for unsupervised (takeaway) dosing when the client has a confirmed allergy to naloxone, or is pregnant. In most jurisdictions where takeaway dosing is allowed, clients on buprenorphine are given the combination buprenorphine/naloxone product. It is important to note that currently no distinction is made between buprenorphine and buprenorphine/naloxone by New South Wales in their data collection therefore both these products are reported in this bulletin under the category of buprenorphine. 
Terminology
The main counts of the NOPSAD collection in 2009 are prescribers, dosing point sites and clients (see Box 2 for definitions). Full definitions may be found in the National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) 2009 Data collection data guide (AIHW 2009).
It is important to remember that counts in the NOPSAD collection relate to a particular day. The use of a ‘snapshot/specified’ day allows the number of clients to be estimated at a single point in time. The ‘snapshot/specified’ day varies slightly between jurisdictions. Snapshot data provide a glimpse of pharmacotherapy treatment activity on a specified day but do not capture the total estimated activity throughout any given year. However, snapshot data are considered to be a good representation of the total client base.

Box 2: Key definitions for the NOPSAD collection
Prescriber refers to a registered prescriber who has undergone accreditation and/or authorisation to prescribe a pharmacotherapy drug, and who has not been recorded as ceasing this registration prior to the ‘snapshot/specified’ day.
More specifically, a prescriber should be included in the count if they are either:
	–  a registered or authorised prescriber
	–  an active prescriber who is scripting at least one client over the reporting period
	(i.e. financial year).
Pharmacotherapy dosing point site refers to the dosing point site at which at least one client is provided a pharmacotherapy drug on the ‘snapshot/specified’ day. 
Dosing point sites include: 
	–  public clinics
	–  private clinics
	–  pharmacies
	–  correctional settings
	–  other,  i.e. hospitals (inpatients or outpatients), community health centres, doctors’ surgeries and ‘Not stated’ dosing points sites.
Client refers to a person registered as receiving opioid pharmacotherapy treatment on the ‘snapshot/specified’ day. 

Client, prescriber and dosing point site counts can be defined as follows: 
•	Client counts in the NOPSAD collection relate to the number of clients accessing pharmacotherapy treatment on a ‘snapshot/specified’ day. 
•	Prescriber counts relate to the number of registered prescribers who are authorised to script at least one client over the reporting period (that is, over the financial year). 
•	Dosing point site counts relate to the number of dosing point sites at which clients are provided pharmacotherapy drugs over the reporting period (that is, on the ‘snapshot/specified’ day). 
Administrative features in each jurisdiction
Each state and territory uses a slightly different method to collect data on pharmacotherapy prescription and dosing (Table 1). These are driven by jurisdictional differences, such as legislation, computer systems and resources. These differences may result in minor discrepancies when comparing one jurisdiction with another.
Table 1: Administrative features of the NOPSAD collection in each jurisdiction
Jurisdiction	Methodology	
New South Wales	The Pharmacotherapy Drugs of Addiction System (PHDAS) is primarily used to assist the administration of the NSW Opioid Treatment Program. Information reported into the database is used to inform the issuing of authority to doctors to prescribe as part of the NSW Opioid Treatment Program. The database also records patient admissions and exits into and out of treatment, as well as details of approved prescribers and dosing points. For these reasons, PHDAS is characterised by continual fluctuations and data extracted at different times for the same period may not be the same. However, while delays in reporting entries into the program, exits from the program, and changes in the status of dosing points cause short-term fluctuations in the database, these fluctuations flatten out over the course of a full year. 
Client data are reported in New South Wales as at 30 June.	
Victoria	Data are collected from:
a quarterly census of pharmacists, whereby pharmacists are requested to report the actual number of clients being dosed on a specified day
the permit database, which records information about practitioners authorised to prescribe pharmacotherapy drugs, as well as demographic information about clients accessing pharmacotherapy treatment.
These two data sources cannot be linked.
The Victorian pharmacotherapy system is essentially entirely community-based, other than inpatients in hospitals and in prisons. Although a small number of services receives government funding they are independent bodies and services and are not managed directly by government.
Client data are reported in Victoria on a specified day.	
Queensland	Data are collected monthly from pharmacists and entered into a central database managed by the Drugs of Dependence Unit. Data are also collected from the administrative ‘Admission’ and ‘Discharge’ forms. National and Queensland totals may vary slightly due to these data source differences. For example, a client may be counted as registered and having received a dose on a snapshot day but a dosing point cannot be assigned because the dose consumed on a snapshot day was a takeaway dose.
Client data for Queensland are reported on a specified day.	
Western Australia	Data are collected monthly from pharmacists and entered into a central database Monitoring of Drugs of Dependence System (MODDS) managed by the Pharmaceutical Services Branch. Data are also collected from the ‘Application for authority’, ‘Authority to prescribe’ and ‘Termination of treatment’ forms.
Client data are reported in Western Australia for the entire month of June. Prior to 2005, Western Australia reported clients over a year.	
(continued)

Table 1 (continued): Administrative features of the NOPSAD collection in each jurisdiction
Jurisdiction	Methodology	
South Australia	Data are collected from the forms ‘Application for authority’, ‘Termination of treatment’, ‘Authority to prescribe’ and ‘Request for takeaway doses’, which are entered into a central database system at Drug and Alcohol Services South Australia (DASSA). Information from scripts are also collected electronically from pharmacists monthly and sent to DASSA. 
From 2007, data are collected via a quarterly census of pharmacists and reported on a specified day. Other data are drawn from the Drugs of Dependence Unit’s Drugs of Misuse Surveillance System and are about those clients registered for treatment on the specified day (but who may not actually receive treatment on that day).	
Tasmania	Data are collected from pharmacists participating in the Tasmanian Pharmacotherapy Program, and stored in the Drug and Alcohol Pharmacy Information System (DAPIS). This central database is managed through the Pharmaceutical Services Unit, and is a ‘live’ database, from which a snapshot for any day can be taken.
Client data are reported in Tasmania on a specified day.	
Australian Capital Territory	Client participation data are collected from the Alcohol and Drug Program databases and from prescription dosing records provided by community pharmacies. General practitioner and pharmacy participation data are collected from the Chief Health Officer’s records and quarterly phone contact.
Client data are reported in the Australian Capital Territory on a specified day.	
Northern Territory 	Prescribers complete the forms ‘Authority’, ‘Variation’ and ‘Cessation’, and submit them to the Department of Health and Community Services Poisons Control for entry into a central database. Pharmacies also submit copies of scripts to the same database. The Northern Territory aggregates data throughout the year.
Client data are reported in the Northern Territory on a specified day.	
Clients receiving pharmacotherapy treatment
Numbers of clients 
Nationally, an estimated 43,445 clients were receiving pharmacotherapy treatment on the ‘snapshot/specified’ day in June 2009 (Tables 2 and 3). This is an increase of 2,098 from June 2008 and an overall increase of 4,602 from 2007. From 2004 to 2007 the figure remained relatively stable, after an increase of over 50% from 1998 (24,657 clients) to 2004 (38,741).
Of the total, the largest proportion of clients resides in New South Wales (41%), followed by Victoria (29%) and Queensland (12%) (Table 3). Western Australia and South Australia each provided services to approximately 7% of clients receiving pharmacotherapy treatment in Australia in 2009. 

Table 2: Total number of pharmacotherapy clients receiving pharmacotherapy treatment on a ‘snapshot/specified’ day by state and territory, 1998–2009 
	NSW	Vic	Qld	WA(a)	SA(b)	Tas	ACT	NT	Australia	
1998	12,107	5,334	3,011	1,654	1,839	306	406	—	24,657	
1999	12,500	6,700	3,341	2,449	1,985	370	559	2	27,906	
2000	13,594	7,647	3,588	2,140	2,198	423	615	32	30,237	
2001	15,069	7,743	3,745	2,307	2,522	464	641	25	32,516	
2002	15,471	7,700	3,896	3,602	2,417	513	590	21	34,210	
2003	16,165	8,685	4,289	4,079	2,486	498	686	98	36,986	
2004	15,719	10,003	4,470	4,437	2,706	576	748	82	38,741	
2005	16,469	10,753	4,440	2,883	2,857	588	764	183	38,937	
2006	16,355	10,736	4,637	2,888	2,823	602	790	134	38,965	
2007	16,348	11,051	4,309	2,822	2,834	600	765	114	38,843	
2008	17,168	11,821	4,899	2,908	3,052	588	786	125	41,347	
2009	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	
(a)	In Western Australia the numbers of clients receiving pharmacotherapy treatment are reported through the month of June 2009. The 2005, 2006, 2007, 2008 and 2009 figures reported for Western Australia are substantially lower than previous years, which included data for the whole year.
(b)	In 2008, South Australia made a slight variation to its collection methodology which has resulted in a revision of the total numbers for 2006 (from 2,517 to 2,823) and 2007 from (2,559 to 2,834). This revision has also resulted in a change in the total number of clients for 2006 from 38,659 to 38,965 and 2007 from 38,568 to 38,843. 
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
Type of pharmacotherapy 
On the ‘snapshot/specified’ day in 2009, approximately 70% of clients registered for pharmacotherapy treatment were receiving methadone and the remaining 30% received buprenorphine or the combination product buprenorphine/naloxone (Figure 1).
The changes between the proportions of clients on buprenorphine and buprenorphine/naloxone (see Figure 1) need to be interpreted with caution. While it shows that the proportion of clients taking buprenorphine/naloxone has almost tripled, this may be mostly accounted for by changes over time in how jurisdictions report.

Figure 1: Total proportion of pharmacotherapy clients receiving pharmacotherapy treatment on a ‘snapshot/specified’ day(a)(b), by type of pharmacotherapy provided, 2006–2009
Vertical bar chart showing, for year, per cent on y-axis and treatment ion x-axis.
(a)	In New South Wales, clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(b)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
Source: Table 3.

In New South Wales, clients receiving buprenorphine/naloxone are reported under the category ‘Buprenorphine’. It is important to note that the number of clients receiving buprenorphine/naloxone is an underestimate, since New South Wales was not able to separately identify the number of these clients. This was also the case for Queensland in 2007, and Tasmania/Australian Capital Territory in 2006. Of those jurisdictions able to identify clients receiving buprenorphine/naloxone, dosing for this drug was most common in the Northern Territory, Queensland and Victoria.
Table 3: Total number of pharmacotherapy clients receiving pharmacotherapy treatment on a ‘snapshot/specified’ day(a), by type of pharmacotherapy provided and jurisdiction, 2006,
2007, 2008 and 2009
Pharmacotherapy drug type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Australia	
	2009	
	(Number)	
Methadone	14,415	7,856	2,814	2,172	1,834	472	625	47	30,235	
Buprenorphine	3,453	1,070	750	147	402	75	56	17	5,970	
Buprenorphine/naloxone(b)	—	3,650	1,552	868	601	87	111	57	6,926	
Not reported(c)	—	—	—	—	314	—	—	—	314	
Total	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	
	(Per cent)	
Methadone	80.7	62.5	55.0	68.2	58.2	74.4	78.9	38.8	69.6	
Buprenorphine	19.3	8.5	14.7	4.6	12.8	11.8	7.1	14.0	13.7	
Buprenorphine/naloxone(b) 	—	29.0	30.3	27.2	19.1	13.7	14.0	47.1	15.9	
Not reported(c)	—	—	—	—	10.0	—	—	—	0.7	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Per cent of all clients by jurisdiction	41.1	28.9	11.8	7.3	7.3	1.5	1.8	0.3	100.0	
	2008	
	(Per cent)	
Methadone	81.4	60.6	56.1	68.6	63.2	81.6	76.0	39.2	70.0	
Buprenorphine	18.6	10.2	14.1	6.2	18.5	9.2	11.3	18.4	14.5	
Buprenorphine/naloxone(b)	—	29.2	29.9	25.2	18.3	9.2	12.7	42.4	15.5	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Per cent of all clients by jurisdiction	41.5	28.6	11.8	7.0	7.4	1.4	1.9	0.3	100.0	
	2007	
	(Per cent)	
Methadone	83.2	60.0	62.1	69.3	64.2	85.3	79.3	42.1	71.7	
Buprenorphine	16.8	14.0	37.9	8.7	21.7	12.2	10.8	29.8	18.0	
Buprenorphine/naloxone(b)	—	26.0	—	21.9	14.1	2.5	9.8	28.1	10.3	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Per cent of all clients by jurisdiction	42.4	28.7	11.2	7.3	6.6	1.6	2.0	0.3	100.0	
(continued)	
Table 3 (continued): Total number of pharmacotherapy clients receiving pharmacotherapy treatment on a ‘snapshot/specified’ day(a), by type of pharmacotherapy provided and jurisdiction, 2006, 2007, 2008 and 2009
Pharmacotherapy drug type	NSW	Vic	Qld	WA(a)	SA	Tas	ACT	NT	Australia	
	2006	
	(Per cent)	
Methadone	83.9	59.6	61.2	64.8	62.5	86.5	75.9	53.0	71.4	
Buprenorphine	16.1	26.8	38.8	18.8	30.9	13.5	24.1	30.6	23.2	
Buprenorphine/naloxone(b)	—	13.6	—	16.4	6.6	—	—	16.4	5.5	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Per cent of all clients by jurisdiction	42.3	27.8	12.0	7.5	6.5	1.6	2.0	0.3	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
(b)	 In New South Wales, clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(c)	The total of 314 in the ‘Not reported’ row for South Australia is the number of clients who did not enter a dosing point on the ‘snapshot/specified day’. The breakdowns provided under the individual drug headings in this row are estimates.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in 
minor discrepancies if directly comparing one jurisdiction with another jurisdiction. 
Since 2006, the uptake of buprenorphine/naloxone as a pharmacotherapy treatment has been increasing. Of the jurisdictions able to identify clients receiving buprenorphine/naloxone, the largest increases in the proportion of clients receiving this treatment in the year 2009 were seen in the Northern Territory and Tasmania (both increased by 5 percentage points) and in Western Australia (which increased by 2 percentage points) (Table 3).
The proportions of clients prescribed methadone, buprenorphine or buprenorphine/ naloxone varied across jurisdictions (Table 3), although the majority of clients in most jurisdictions were prescribed methadone in 2009. The Northern Territory was the exception with 47% of clients being prescribed buprenorphine/naloxone and 39% being prescribed methadone.
Prescribers of pharmacotherapy drugs
As described earlier, every jurisdiction has regulations about which medical practitioners can prescribe a pharmacotherapy drug. Not all prescribers are authorised or registered to prescribe both methadone and buprenorphine. 
In the 2008–09 financial year, there were 1,350 practitioners nationally that were authorised to prescribe pharmacotherapy drugs. Of these:
•	71% (953) were registered to prescribe more than one drug type
•	25% (337) were registered to prescribe methadone only 
•	4% (59) were registered for buprenorphine only
•	less than 1% were registered for buprenorphine/naloxone only.
Prescribers in South Australia, The Australian Capital Territory and the Northern Territory follow a single accreditation process which allows them to prescribe all pharmacotherapy drugs. 
There have been some variations in the number of prescriber registrations in each jurisdiction since 2005 (Table 4). Up until 2008, Victoria continued to account for the largest proportion of prescribers, however in 2009, New South Wales had the highest proportion of prescribers (39%) followed by Victoria (34%), and Queensland (9%). 
The data presented in Table 4 relate to all ‘registered prescribers’, except for those in New South Wales and South Australia where they report on ‘active prescribers’ only. 
Table 4: Estimated number of prescribers registered to prescribe pharmacotherapy drugs by drug type and jurisdiction, 2005–2009
Pharmacotherapy drug type	NSW(a)	Vic	Qld(b)	WA(c)	SA	Tas(d)	ACT	NT	Total	Total %	
	2009	
Methadone only	228	84	4	—	—	12	9	—	337	25.0	
Buprenorphine only(e)	58	—	1	—	—	—	—	—	59	4.4	
Buprenorphine/naloxone only	—	—	1	—	—	—	—	—	1	0.1	
Authorised to prescribe more than one drug type	242	373	115	92	73	23	27	8	953	70.6	
Total (no.)	528	457	121	92	73	35	36	8	1,350	100.0	
Total (per cent)	39.1	33.9	9.0	6.8	5.4	2.6	2.7	0.6	100.0	..	
	2008	
Methadone only	199	122	2	14	—	24	10	—	371	26.6	
Buprenorphine only(e)	39	—	1	—	—	18	—	—	58	4.2	
Buprenorphine/naloxone only	—	—	1	—	—	5	—	—	6	0.4	
Authorised to prescribe more than one drug type	257	407	107	69	74	5	26	13	958	68.8	
Total (no.)	495	529	111	83	74	52	36	13	1393	100.0	
Total (per cent)	35.5	38.0	8.0	6.0	5.3	3.7	2.6	0.9	100.0	..	
	2007	
Methadone only	176	122	2	15	—	29	11	—	355	27.4	
Buprenorphine only(e)	30	—	5	1	—	18	—	—	54	4.2	
Buprenorphine/naloxone only	—	—	—	—	—	5	—	—	5	0.4	
Authorised to prescribe more than one drug type	246	371	92	70	74	—	14	14	881	68.0	
Total (no.)	452	493	99	86	74	52	25	14	1,295	100.0	
Total (per cent)	34.9	38.1	7.6	6.6	5.7	4.0	1.9	1.1	100.0	.. 	
	2006	
Methadone only	123	122	9	15	—	—	13	—	282	23.1	
Buprenorphine only(e)	287	—	5	1	—	—	12	—	305	25.0	
Buprenorphine/naloxone only 	—	—	—	—	—	—	—	—	—	—	
Authorised to prescribe more than one drug type	—	341	120	52	65	48	—	7	633	51.9	
Total (no.)	410	463	134	68	65	48	25	7	1,220	100.0	
Total (per cent)	33.6	38.0	11.0	5.6	5.3	3.9	2.0	0.6	100.0	..	
(continued)	

Table 4 (continued): Estimated number of prescribers registered to prescribe pharmacotherapy drugs by drug type and jurisdiction, 2005–2009
Pharmacotherapy drug type	NSW(a)	Vic	Qld(b)	WA(c)	SA	Tas(d)	ACT	NT	Total	Total %	
	2005	
Methadone only	123	112	10	15	—	42	13	—	315	25.5	
Buprenorphine only(e)	—	—	1	1	—	—	—	—	2	0.2	
Methadone and buprenorphine 	293	316	114	56	73	39	15	11	917	74.3	
Total (no.)	416	428	125	72	73	81	28	11	1,234	100.0	
Total (per cent)	33.7	34.7	10.1	5.8	5.9	6.6	2.3	0.9	100.0	..	
 (a)	In New South Wales, practitioners authorised to prescribe methadone can additionally be approved to prescribe buprenorphine, but not vice versa. Medical practitioners who manage up to five clients do not require an approval to prescribe drugs of addiction under Section 28A of the 1966 Poisons and Therapeutic Goods Act and are not required to complete pharmacotherapy training. The figures provided for New South Wales represent the type of drugs prescribed by active prescribers on 30 June rather than the number of prescribers approved to prescribe each drug type. 
(b)	The total for Queensland includes those prescribers from private practice, public clinics, correctional centres and government medical offices.
(c)	In Western Australia, prescriber training is provided for all pharmacotherapies currently available. The total number of prescribers includes those treating at least one client as at 30 June 2009 in private practice, public clinics and correctional centres.
(d)	In Tasmania, training is provided separately for each pharmacotherapy drug.
(e)	New South Wales data collection does not differentiate between prescribers who are authorised to prescribe buprenorphine and those authorised to prescribe buprenorphine/naloxone.
Notes
1.	Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
2.	‘Authorised to prescribe more than one drug type’ was not a valid response code in 2005.
3.	The data presented in this table relate to all ‘registered prescribers’, except for prescribers in New South Wales and South Australia where they report on ‘active prescribers’ only.
4.	Data on ’Buprenorphine/naloxone only’ prescribers were not reported in 2005 and 2006. However in 2006, buprenorphine/naloxone was available for prescription but no instances of ‘Buprenorphine/naloxone only’ prescribers were reported. 
Prescriber type
Of the 43,445 estimated clients authorised to receive pharmacotherapy treatment on the ‘snapshot/specified’ day in June 2009 (Table 5):
•	64% (or 27,838) received the treatment from a private prescriber
•	27% (or 11,705) received the treatment from a public prescriber
•	8% (or 3,454) received treatment from a practitioner in a correctional facility. 
Table 5: Estimated number of pharmacotherapy clients by pharmacotherapy drug type and prescriber type on a ‘snapshot/specified’ day(a), 2005–2009
Prescriber type	Methadone	Buprenorphine	Buprenorphine/ naloxone(b)	All drug types	
	2009	
	(Number)	
Public Prescriber	8,244	2,047	               1,414 	11,705	
Private Prescriber	18,730	3,661	   5,447 	27,838	
Public/Private Prescriber(c)	326	122	 — 	448	
Correctional Facilities	3,055	209	                     190 	3,454	
Total	30,355	6,039	          7,051 	43,445	
	(continued)	
Table 5 (continued): Estimated number of pharmacotherapy clients by pharmacotherapy drug type and prescriber type on a ‘snapshot/specified’ day(a), 2005–2009
Prescriber type	Methadone	Buprenorphine	Buprenorphine/ naloxone(b)	All drug types	
	(Per cent)	
Public Prescriber	27.2	33.9	20.1	26.9	
Private Prescriber	61.7	60.6	77.3	64.1	
Public/Private Prescriber(c)	1.1	2.0	—	1.0	
Correctional Facilities	10.1	3.5	2.7	8.0	
Total	100.0	100.0	100.0	100.0	
	2008 	
	(Per cent)	
Public Prescriber	27.3	31.7	20.4	26.9	
Private Prescriber	62.8	63.6	76.1	65.0	
Public/Private Prescriber(c)	1.2	1.8	—	1.1	
Correctional Facilities	8.7	2.9	3.5	7.0	
Total	100.0	100.0	100.0	100.0	
		2007		
		(Per cent)		
Public Prescriber	27.8	36.2	10.0	27.5	
Private Prescriber	61.4	59.6	86.1	63.6	
Public/Private Prescriber(c)	1.3	1.2	—	1.2	
Correctional Facilities	9.5	3.0	3.9	7.7	
Total(d)	100.0	100.0	100.0	100.0	
	2006	
	(Per cent)	
Public Prescriber	28.3	30.1	8.2	27.7	
Private Prescriber	61.9	65.2	91.3	64.2	
Public/Private Prescriber(c)	1.4	1.0	—	1.2	
Correctional Facilities	8.4	3.7	0.5	6.9	
Total	100.0	100.0	100.0	100.0	
	2005	
	(Per cent)	
Public Prescriber	23.3	20.9	n.a.	23.5	
Private Prescriber	68.7	75.9	n.a.	69.8	
Public/Private Prescriber(c)	0.2	0.1	n.a.	0.1	
Correctional Facilities	7.8	3.0	n.a.	6.6	
Total	100.0	100.0	n.a.	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except Western Australia, where the number of clients treated   through the month of June is reported.
(b)	In New South Wales clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(c)	In New South Wales, these figures relate to prescribing that cannot be segregated into public or private prescribers.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
Clients per prescriber 
Nationally in 2009, there were a total of 1,350 prescribers who were registered to prescribe pharmacotherapy treatment for 43,445 clients (though not all of these practitioners were actively prescribing). South Australia had the largest average number of clients per prescriber (43), followed by Queensland (42), Western Australia (35) and New South Wales (34).
The average number of clients per prescriber (Figure 2) has remained relatively stable nationally from 2005 to 2009 (in the range of 30 to 32 clients per prescriber). Specifically, the average number of clients has risen in Tasmania from 2005 (7) to 2009 (18) and in Queensland from 2005 (36) to 2009 (42). A decline was recorded in New South Wales from 2005 (40) to 2009 (34), in Western Australia from 2006 (42) to 2009 (35), and in the Australian Capital Territory from 2006 (32) to 2009 (22). Other states and territories have fluctuated over time. Appendix Table A6 provides a further breakdown of pharmacotherapy clients and prescribers by jurisdiction.
Figure 2: Average number of pharmacotherapy clients per prescriber on ‘snapshot/specified’ day by jurisdiction 2005–2009.
Vertical bar chart showing, for year, number on y-axis and state/territory on x-axis.
Source: Appendix Table A6.
Pharmacotherapy dosing point sites
A pharmacotherapy dosing point site relates to the physical setting in which a pharmacotherapy drug is provided to a client, regardless of whether the drug intake is supervised or the dose taken away. 
On the ‘snapshot/specified’ day in 2009 there were 2,157 pharmacotherapy dosing sites (Table 6). Of these, the majority (85%) were located in pharmacies. The remainder were located in public clinics, correctional facilities, private clinics and other locations.
New South Wales had the highest number of dosing point sites (709), followed by Queensland (474) and Victoria (436). 
In 2008–09, South Australia and the Australian Capital Territory recorded a small decrease in dosing point sites. The Northern Territory reported a relatively larger decrease in the number of dosing point sites compared with 2008. New South Wales, Tasmania, Victoria, and Queensland recorded small increases in the number of dosing point sites while Western Australia remained stable.

Table 6: Number of pharmacotherapy dosing point sites by jurisdiction, 2005–06 to 2008–09
Dosing point sites	NSW(a)	Vic(b)	Qld	WA	SA	Tas	ACT	NT	Australia	Total %	
	2008–09	
Public clinic	37	—	10	1	2	1	1	2	54	2.5	
Private clinic	12	3	—	—	—	—	—	—	15	0.7	
Pharmacy	572	407	354	235	185	52	26	7	1,838	85.2	
Correctional setting	1	10	12	2	9	1	1	2	38	1.8	
Other	87	16	98	9	2	—	—	—	212	9.8	
Total (no.)	709	436	474	247	198	54	28	11	2,157	100.0	
Total (per cent)	32.9	20.2	22.0	11.5	9.2	2.5	1.3	0.5	100.0	..	
	2007–08	
Public clinic	37	—	10	1	2	1	1	3	55	2.6	
Private clinic	12	3	—	—	—	—	—	—	15	0.7	
Pharmacy	558	403	353	233	189	48	26	10	1,820	84.9	
Correctional setting	2	10	16	2	10	1	2	2	45	2.1	
Other	89	15	91	11	2	—	—	—	280	9.7	
Total (no.)	698	431	470	247	203	50	29	15	2,143	100.0	
Total (per cent)	31.6	20.1	21.3	11.2	9.2	2.3	1.3	0.7	100.0	..	
	2006–07	
Public clinic	37	—	12	1	2	1	1	2	56	2.6	
Private clinic	12	3	—	—	—	—	—	—	15	0.7	
Pharmacy	547	395	366	239	202	47	25	8	1,829	85.7	
Correctional setting	2	17	16	2	8	1	2	2	50	2.3	
Other 	82	10	90	—	3	—	—	—	185	8.7	
Total (no.)	680	425	484	242	215	49	28	12	2,135	100.0	
Total (per cent)	31.3	19.9	22.3	11.1	9.9	2.3	1.3	0.6	100.0	..	
	2005–06	
Public clinic	36	—	14	1	2	1	1	1	56	2.7	
Private clinic	12	3	—	—	—	—	—	—	15	0.7	
Pharmacy	533	385	378	241	164	46	25	7	1,779	85.5	
Correctional setting	1	10	20	2	6	1	2	2	44	2.1	
Other 	78	15	91	—	3	—	—	—	187	9.0	
Total (no.)	660	413	503	244	175	48	28	10	2,081	100.0	
Total (per cent)	30.9	19.8	23.5	11.4	8.2	2.2	1.3	0.5	100.0	..	
(a)	In New South Wales, figures relate to dosing point sites that were dosing at least one client as at 30 June 2009. The category 'Other' includes hospitals as well as a small number of general practices. ‘Other’ also includes when the dosing point site was not stated. One juvenile justice centre dispensed pharmacotherapies. Individual adult correctional facilities cannot be distinguished.
(b)	The figures reported for Victoria for dosing point sites in ‘Pharmacies’, ‘Correctional settings’ and ‘Other’ for the periods 2007–08, 2007–06 and 2006–05 have been revised, and are different from the figures in previous bulletins.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
As previously reported in this bulletin, dosing point sites were most commonly located in pharmacies. The proportion of clients receiving buprenorphine/naloxone who were dosed at a pharmacy (84%) was higher than clients receiving methadone (68%) or buprenorphine only (57%) at a pharmacy (Table 7). The proportion of clients receiving buprenorphine/naloxone at pharmacies has decreased since 2007 from 93% to 84% in 2009. The proportion of clients accessing buprenorphine from pharmacies also declined from 70% in 2007 to 57% in 2009. The proportion of clients accessing methadone from pharmacies has remained relatively stable for this same period.
Table 7: Estimated number of pharmacotherapy clients by pharmacotherapy drug type and dosing point site on a ‘snapshot/specified’ day(a)(b), 2006–2009 
Dosing point site	Methadone	Buprenorphine	Buprenorphine/
naloxone(c)	All drug types	
	2009	
	(Number)	
Public clinic	2,892	994	196	4,082	
Private clinic	2,438	784	12	3,234	
Pharmacy	20,671	3,435	5,897	30,003	
Correctional setting	2,966	195	167	3,328	
Other(d) (e)	1,388	627	783	2,798	
Total	30,355	6,035	7,055	43,445	
	(Per cent)	
Public clinic	9.5	16.5	2.8	9.4	
Private clinic	8.0	13.0	0.2	7.4	
Pharmacy	68.1	56.9	83.6	69.1	
Correctional setting	9.8	3.2	2.4	7.7	
Other(d) (e)	4.6	10.4	11.4	6.4	
Total	100.0	100.0	100.0	100.0	
	2008	
	(Per cent)	
Public clinic	10.7	14.9	2.9	10.1	
Private clinic	8.4	12.7	0.2	7.7	
Pharmacy	67.6	59.8	86.9	69.4	
Correctional setting	8.8	2.9	3.0	7.1	
Other(d) (e)	4.5	9.7	7.0	5.7	
Total	100.0	100.0	100.0	100.0	
	2007	
	(Per cent)	
Public clinic	11.9	14.2	2.2	10.8	
Private clinic	8.9	9.8	0.7	8.8	
Pharmacy	67.1	69.6	93.0	68.9	
Correctional setting	9.3	2.7	4.1	8.9	
Other(d)	2.8	3.7	—	2.7	
Total	100.0	100.0	100.0	100.0	
(continued)
Table 7 (continued): Estimated number of pharmacotherapy clients by pharmacotherapy drug type and dosing point site on a ‘snapshot/specified’ day(a)(b), 2006–2009
Dosing point site	Methadone	Buprenorphine	Buprenorphine/
naloxone(c)	All drug types	
	2006(f)	
	(Per cent)	
Public clinic	12.9	12.7	1.5	12.3	
Private clinic	9.3	8.5	1.8	8.7	
Pharmacy	67.4	73.9	94.5	70.4	
Correctional setting	8.5	3.5	2.2	7.0	
Other(d) 	1.9	1.5	—	1.7	
Total	100.0	100.0	100.0	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
(b)	Queensland excluded clients who were not physically dosed on the 'snapshot/specified' day. That is, they physically received a double or triple dose of buprenorphine prior to the ‘snapshot/specified’ day which would have remained in their systems to cover the 'snapshot/specified' day (valid for 2006 and 2007). 
(c)	In New South Wales clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’. 
(d)	In New South Wales the category 'Other' includes clients dosed at hospitals, as hospital inpatients or hospital outpatients, as well as a small number of clients dosed in general practices. 'Other' also includes persons for whom the dosing point was not stated. 
(e) 	In 2009, ‘Other’ includes 314 clients who did not enter a dosing point on the ‘snapshot/specified’ day in South Australia. 
	In 2008, ‘Other’ includes 639 clients in Queensland and 279 clients in South Australia who had received a takeaway dose prior to the ‘snapshot/specified’ day. For additional information please see Appendix A2.
In Queensland the category ‘Other’ was calculated by including the number for all clients who had prescriptions filled at the dosing points and assuming that all other clients had received takeaways, double doses, etc. (Not collected from dosing point).
 (f)	The total estimated number of clients reported in Table 7 in 2006 excludes pharmacotherapy clients in the Northern Territory as data relating to dosing point sites and clients were not available.
 Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
Clients per dosing point
In 2009, there were 2,157 dosing point sites across Australia and 43,445 pharmacotherapy clients. 
The average number of clients per dosing point site has gradually risen over the past three years from 18 in 2007 to 20 in 2009 (Figure 3). There has been a decrease in some states and territories in the number of pharmacotherapy dosing point sites while the number of clients is increasing. South Australia and the Australian Capital Territory both recorded an increase in the number of pharmacotherapy clients and a small decrease in the number of dosing point sites available in 2009. New South Wales, Victoria and Queensland all had an increase in client numbers in 2009 along with a small increase in the number of dosing point sites. In Western Australia an increase in the number of pharmacotherapy clients of 207 was recorded while the number of dosing point sites remained the same at 247. The Northern Territory was the only jurisdiction that saw an increase in the number of pharmacotherapy clients and a reduction in dosing point sites. 

Figure 3: Average number of pharmacotherapy clients by dosing point site on a ‘snapshot/specified’ day, by jurisdiction, 2006–2009.
Vertical bar chart showing, for year, number on y-axis and state/territory on x-axis.
Source: Appendix Table A6
Appendix Table A6 provides a further breakdown of pharmacotherapy clients and dosing points by jurisdiction.
Pharmacy dosing
In 2009, there were 5,084 pharmacies across Australia. Of these approved pharmacies, 1,838 were pharmacotherapy dosing point sites. This proportion nationally has stayed relatively stable over time (37% in 2006 and 36% in 2009) (Figure 4).
In 2009, Western Australia had the highest proportion of dosing pharmacies (46%), followed by South Australia (45%) and the Australian Capital Territory (42%). There was an increase in the proportion of dosing pharmacies in Tasmania from 35% in 2006 to 38% in 2009. New South Wales and Victoria have seen very small increases over time. The proportion of dosing pharmacies has declined since 2006 in Queensland and Western Australia and declined over the past three reporting periods in South Australia. The Northern Territory recorded a recent decrease of dosing pharmacies from 36% in 2008 to 24% in 2009.  
Figure 4: Proportion of approved pharmacies dosing pharmacotherapy treatment over time by jurisdiction, 2006–2009.
Vertical bar chart showing, for year, per cent on y-axis and state/territory on x-axis.
Source: DoHA 2009 RPC015.
Demographic profile of clients receiving pharmacotherapy treatment
Sex
Of the 43,445 estimated clients authorised to receive pharmacotherapy treatment on the ‘snapshot/specified’ day in June 2009, 28,198 (65%) were male (Table 8). There was little variation by gender and by drug type (proportion of males on methadone is 64%, on buprenorphine 67%, buprenorphine/naloxone 66%). The proportions of male and female clients have remained stable since 2006.
Appendix Table A3 provides further breakdown of pharmacotherapy drug type by sex and jurisdiction.

Table 8: Estimated number of pharmacotherapy clients by pharmacotherapy drug type and sex of the client on a ‘snapshot/specified’ day, 2006, 2007, 2008 and 2009
Sex	Methadone	Buprenorphine	Buprenorphine/
Naloxone(a)	All drug types	
	2009	
	(Number)	
Male	19,469	4,051	4,678	28,198	
Female	10,828	1,979	2,344	15,151	
Not stated	58	9	29	96	
Total	30,355	6,039	7,051	43,445	
	(Per cent)	
Male	64.1	67.1	66.4	64.9	
Female	35.7	32.8	33.2	34.9	
Not stated	0.2	0.1	0.4	0.2	
Total	100.0	100.0	100.0	100.0	
		2008		
		(Per cent)		
Male	63.4	67.0	66.7	64.4	
Female	36.1	32.8	32.6	35.1	
Not stated	0.5	0.3	0.7	0.5	
Total	100.0	100.0	100.0	100.0	
		2007		
	(Per cent)	
Male	63.1	66.5	66.6	64.1	
Female	36.4	33.1	32.6	35.4	
Not stated	0.5	0.4	0.8	0.5	
Total	100.0	100.0	100.0	100.0	
	2006	
	(Per cent)	
Male	62.8	67.9	65.5	64.2	
Female	36.8	31.6	33.3	35.4	
Not stated	0.3	0.5	1.1	0.4	
Total	100.0	100.0	100.0	100.0	
(a)	In New South Wales, clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’. 
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
Age group
For the 2009 collection, all jurisdictions except the Northern Territory were able to provide information on the age group of clients receiving pharmacotherapy treatment. 
The majority of clients (86%) were aged between 20 and 49 years of age. Those 30–39 years of age made up the largest proportion of clients (40%). Those aged 40–49 years made up 29% and those aged 20–29 years made up 18% of clients (Table 9). Proportionally there was a decrease over time amongst the clients aged 29 years or younger and an increase proportionally amongst those aged 40 years and over.
Table 9: Estimated number of pharmacotherapy clients by pharmacotherapy drug type and age group of the client on a ‘snapshot/specified’ day(a), 2006–2009
Age group	Methadone	Buprenorphine	Buprenorphine/
Naloxone	All drug types	
	2009	
	(Number)	
10–19 years	78	35	19	132	
20–29 years	4,959	1,274	1,403	7,636	
30–39 years	11,685	2,515	3,113	17,313	
40–49 years	9,128	1,567	1,783	12,478	
50–59 years	4,200	587	625	5,412	
60 years and over	259	43	51	353	
Sub total(b)	30,309	6,021	6,994	43,324	
Not reported	46	18	57	121	
Total	30,355	6,039	7,051	43,445	
	(Per cent)	
10–19 years	0.3	0.6	0.3	0.3	
20–29 years	16.4	21.2	20.1	17.6	
30–39 years	38.6	41.8	44.5	39.9	
40–49 years	30.1	26.0	25.5	28.7	
50–59 years	13.9	9.7	8.9	12.5	
60 years and over	0.9	0.7	0.7	0.8	
Sub total(b)	99.8	99.7	99.2	99.7	
Not reported	0.2	0.3	0.8	0.3	
Total	100.0	100.0	100.0	100.0	
		2008		
		(Per cent)		
10–19 years	0.4	0.7	0.8	0.5	
20–29 years	20.8	27.0	27.9	22.8	
30–39 years	36.9	40.1	42.5	38.2	
40–49 years	29.3	23.5	21.9	27.3	
50–59 years	12.0	8.1	6.4	10.6	
60 years and over	0.6	0.5	0.5	0.5	
Sub total(b)	99.8	99.6	99.1	99.7	
Not reported	0.2	0.4	0.9	0.3	
Total	100.0	100.0	100.0	100.0	
(continued)

Table 9 (continued): Estimated number of pharmacotherapy clients by pharmacotherapy drug type and age group of the client on a ‘snapshot/specified’ day(a), 2006–2009
Age group	Methadone	Buprenorphine	Buprenorphine/
Naloxone	All drug types	
		2007		
	(Per cent)	
10–19 years	0.3	0.5	0.3	0.3	
20–29 years	20.5	27.0	25.0	22.2	
30–39 years	37.4	40.4	44.3	38.6	
40–49 years	30.1	24.0	22.6	28.3	
50–59 years	11.2	7.6	7.2	10.1	
60 years and over	0.5	0.5	0.6	0.5	
Total	100.0	100.0	100.0	100.0	
	2006	
	(Per cent)	
10–19 years	0.6	1.0	1.0	0.7	
20–29 years	24.9	34.1	35.6	27.7	
30–39 years	36.2	38.4	40.3	36.9	
40–49 years	29.3	21.1	18.8	26.9	
50–59 years	8.7	5.1	4.2	7.6	
60 years and over	0.3	0.3	0.2	0.3	
Total	100.0	100.0	100.0	100.0	
(a)	In New South Wales, clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(b)	The subtotal number of clients reported in 2008 and 2009 excludes pharmacotherapy clients in the Northern Territory where data relating to the age group of clients are not available.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
For more detailed information on age and jurisdiction see Appendix Table A4. For more information on client age groups see Appendix Table A5.
Aboriginal and Torres Strait Islander people 
In 2009, four jurisdictions were able to provide information about the Indigenous status of clients receiving pharmacotherapy treatment—New South Wales, Queensland, South Australia and the Australian Capital Territory (Table 10). 
The ‘Not reported’ category in Table 10 includes pharmacotherapy clients in Victoria, Western Australia, Tasmania and the Northern Territory where data relating to the Indigenous status of clients were not reported. 
Of the 26,927 clients whose Indigenous status could be identified on the ’snapshot/specified’ day, 8% of clients (or 2,252)  identified as being of Aboriginal and/or Torres Strait Islander origin (Table 10), with 79% of clients (or 21,406) identified as being of non-Indigenous origin. For 12% (or 3,269) of clients in the four reporting jurisdictions, the Indigenous status was not stated.
For the jurisdictions that are able to collect Indigenous status of clients, there has been a decrease in the proportion of clients where Indigenous status was ‘Not stated’ from 22% (or 5,285) of clients in 2007 to 12% (or 3,269) of clients in 2009.
Table 10: Estimated number of pharmacotherapy clients by pharmacotherapy drug type, Indigenous status of the client on a ‘snapshot/specified’ day, by jurisdiction, 2009
Indigenous status	NSW(a) 	Vic	Qld	WA	SA	Tas	ACT	NT	Total	Total (%)	
	Methadone	
Indigenous	1,540	n.a.	68	n.a.	151	n.a.	50	n.a.	1,809	9.1	
Non-Indigenous	10,728	n.a.	2,152	n.a.	1,630	n.a.	563	n.a.	15,073	76.1	
Not stated	2,147	n.a.	594	n.a.	174	n.a.	12	n.a.	2,927	14.8	
Sub total	14,415	n.a.	2,814	n.a.	1,955	n.a.	625	n.a.	19,809	100.0	
Not reported(b)	—	7,856	—	2,172	—	472	—	46	10,546	n.a.	
Total	14,415	7,856	2,814	2,172	1,955	472	625	46	30,355	..	
	Buprenorphine	
Indigenous	303	n.a.	26	n.a.	20	n.a.	1	n.a.	779	7.4	
Non-Indigenous	3,038	n.a.	680	n.a.	415	n.a.	53	n.a.	3,800	88.5	
Not stated	112	n.a.	44	n.a.	34	n.a.	2	n.a.	192	4.1	
Sub total	3,453	n.a	750	n.a	469	n.a	56	n.a	4,771 	100.0	
Not reported(b)	—	1,070	—	147	—	76	—	18	1,311	n.a.	
Total	3,453	1,070	750	147	469	76	56	18	6,039	..	
	Buprenorphine/naloxone	
Indigenous	—	n.a.	34	n.a.	53	n.a.	6	n.a.	93	3.9	
Non-Indigenous	—	n.a.	1,447	n.a.	598	n.a.	102	n.a.	2,147	89.8	
Not stated	—	n.a.	71	n.a.	76	n.a.	3	n.a.	150	6.3	
Sub total	—	n.a.	1,552	n.a.	727	n.a.	111	n.a.	2,390 	100.0	
Not reported(b)	—	3,650	—	868	—	86	—	57	4,661	n.a.	
Total	—	3,650	1,552	868	727	86	111	57	7,051	..	
	Total	
Indigenous	1,843	n.a.	128	n.a.	224	n.a.	57	n.a.	2,252	8.4	
Non-Indigenous	13,766	n.a.	4,279	n.a.	2,643	n.a.	718	n.a.	21,406	79.5	
Not stated	2,259	n.a.	709	n.a.	284	n.a.	17	n.a.	3,269	12.1	
Sub total	17,868	n.a.	5,116	n.a.	3,151	n.a.	792	n.a.	26,927	100.0	
Not reported(b)	—	12,576	—	3,187	—	634	—	121	16,518	n.a.	
Total	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	..	
(a)	In New South Wales clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(b)	The ‘Not reported’ row in this table includes pharmacotherapy clients in Victoria, Western Australia, Tasmania and the Northern Territory where data relating to Indigenous status of clients were not reported. Please note the subtotal number of clients in this table does not include these jurisdictions; they are, however, counted in the total number.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction. 

Clients receiving methadone as a pharmacotherapy treatment have the highest ‘Not stated’ response in 2009 (15%) when compared with buprenorphine (4%) and buprenorphine/naloxone (6%) for the four jurisdictions that report.
As with the analysis relating to Indigenous status generally, caution should be taken when interpreting the differences in Indigenous status across drug types due to the proportion (15%) of ‘Not stated’ responses for clients receiving methadone treatment.
Key new policy initiatives 
The availability of prescribers and dosing points and their location limit the number of places available for those clients who could benefit from pharmacotherapy treatment. Most jurisdictions have some limit to the number of clients that any one prescriber can take on. These numbers vary by jurisdiction. In the Australian Capital Territory, there is no limit to the number of clients a prescriber can have when they have received training in opioid maintenance treatment. For prescribers who have not completed the training there is a limit of up to five concurrent clients.  
Many jurisdictions find it difficult to recruit enough GPs to become pharmacotherapy prescribers. Many of the current prescribers are getting close to retirement age and some of these prescribers have a large case load (Newspoint 2008). Targets for recruitment are difficult to meet. For example, Victoria trained 48 GPs in one year which was about 70% of its target.
To overcome this, jurisdictions are looking at strategies to take the pressure off individual prescribers. For example, more flexibility is being provided in Victoria. As of March 2009, the registration requirements for prescribers of Schedule 8 class drugs were amended. Prescribers no longer need special permits to prescribe Schedule 8 drugs for a resident being treated in aged care service, a prisoner being treated in a correctional facility, or an admitted patient being treated in a hospital.
In multipractitioner clinics, a practitioner at the same clinic as the permit holder may treat a client with a Schedule 8 drug without holding a permit issued specifically to him or her, however, the treatment must be in accordance with the permit issued to the permit holder.
Other initiatives including providing training to GP registrars in Victoria and to psychiatric registrars in New South Wales, are designed to help overcome the anticipated shortage of registered prescribers as older registered prescribers retire or cut down on their practice hours. 
In December 2009, the Minister for Health and Ageing, The Hon. Nicola Roxon, MP, announced the recognition of Addiction Medicine as a medical specialty for the purpose of inclusion in the Australian Medical Council list of Australian Recognised Medical Specialties. This will enable GPs to refer clients, where necessary, to a specialist addiction medicine practitioner. This provides GPs who prescribe pharmacotherapy treatment with further specialist support.
In New South Wales, there is now an annual Fellowship in Addiction Medicine and funding for five additional Junior Medical Officers in Area Health Services to improve postgraduate training in Addiction Medicine. New South Wales also provides funding to the Australian College of Physicians for the development of a variety of online training modules and to the Rural Health Education Foundation for behavioural health care training for GPs.  

Data custodianship
Jurisdictions are the data custodians of information collected through the NOPSAD collection within their state or territory. The AIHW is the data custodian of collated national information obtained from each jurisdiction. For the AIHW, data custodianship means responsibility for protection, storage, analysis and dissemination of the data in accordance with the purpose for which the data were collected, the AIHW Act (1987) and other relevant privacy principles. 
Data requests to the AIHW can only be for summarised aggregate tables, as unit record file data do not exist for this collection. This collection is not a national minimum data set.
Additional information about the collection can be found in the National opioid pharmacotherapy statistical annual data (NOPSAD) 2009 collection data guide which is available on the AIHW website: http://www.aihw.gov.au/publications/index.cfm/title/10779.
Related data collections
As in previous years, a subset of the data presented in this report will be included in the forthcoming 2008–09 Annual Report for the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS–NMDS), due for release mid 2010.
If the data you require are not available from the NOPSAD collection, they may be available from the following sources:

•	Alcohol and Other Drug Treatment Services National Minimum Data Set 
Amber Jefferson phone (02) 6244 1000
Australian Institute of Health and Welfare
< http://www.aihw.gov.au/drugs/index.cfm> 
•	Alcohol and Other Drug Treatment Services National Minimum Data Set data cubes
< http://www.aihw.gov.au/drugs/datacubes/index.cfm>
•	National Drug Strategy Household Survey 
Australian Institute of Health and Welfare
< http://www.aihw.gov.au/drugs/ndshs/index.cfm>
•	Pharmaceutical Benefits Scheme. <http://www.health.gov.au/internet/main/publishing.nsf/Content/pbs-stats-pbexp-jun09>

Appendix Tables 
Table A1: Estimated number of pharmacotherapy clients by pharmacotherapy drug type, 
prescriber type and jurisdiction, Australia on a ’snapshot/specified’ day(a) 2009
Prescriber type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Methadone	
Public prescriber	4,235	—	2,046	656	686	205	377	39	8,244	
Private prescriber	8,014	7,215	744	1,231	1,069	254	197	6	18,730	
Public/private prescriber(b) 	326	—	—	—	—	—	—	—	326	
Correctional facility	1,840	641	24	285	200	13	51	1	3,055	
Total	14,415	7,856	2,814	2,172	1,955	472	625	46	30,355	
	Buprenorphine	
Public prescriber	1,338	—	424	36	164	35	36	14	2,047	
Private prescriber	1,810	1,063	319	109	298	38	20	4	3,661	
Public/private prescriber(b)	122	—	—	—	—	—	—	—	122	
Correctional facility	183	7	7	2	7	3	—	—	209	
Total	3,453	1,070	750	147	469	76	56	18	6,039	
	Buprenorphine/naloxone	
Public prescriber	—	—	806	231	186	61	80	50	           1,414 	
Private prescriber	—	3,570	740	619	461	20	31	6	5,447	
Public/private prescriber(b)	—	—	—	—	—	—	—	—	—	
Correctional facility	—	80	6	18	80	5	—	1	190	
Total 	—	3,650	1,552	868	727	86	111	57	7,051	
	Total (all pharmacotherapy drugs)	
Public prescriber	5,573	—	3,276	923	1,036	301	493	103	11,705	
Private prescriber	9,824	11,848	1,803	1,959	1,828	312	248	16	27,838	
Public/private prescriber(b)	448	—	—	—	—	—	—	—	448	
Correctional facility	2,023	728	37	305	287	21	51	2	3,454	
Total	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	
	Total (per cent) (all pharmacotherapy drugs)	
Public prescriber	31.2	—	64.0	29.0	32.9	47.5	62.2	85.1	26.9	
Private prescriber	55.0	94.2	35.2	61.5	58.0	49.2	31.3	13.2	64.1	
Public/private prescriber(b)	2.5	—	—	—	—	—	—	—	1.0	
Correctional facility	11.3	5.8	0.7	9.6	9.1	3.3	6.4	1.7	8.0	
Total (%)	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
(b)	In New South Wales, these figures relate to prescribing that cannot be segregated into public of private prescribers.
	Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.

Table A2: Estimated number of pharmacotherapy clients by pharmacotherapy drug type, dosing point site and jurisdiction, on a ’snapshot/specified’ day(a), 2009
Dosing point site	NSW(b)(c)	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Methadone	
Public clinic	2,584	—	60	32	37	20	153	6	2,892	
Private clinic	2,347	91	—	—	—	—	—	—	2,438	
Pharmacy	6,892	7,056	2,370	1,851	1,590	452	421	39	20,671	
Correctional setting	1,772	641	18	285	198	—	51	1	2,966	
Other	820	68	170	4	9	—	—	—	1,071	
Not reported(d)	—	—	196	—	121	—	—	—	317	
Total	14,415	7,856	2,814	2,172	1,955	472	625	46	30,355	
	Buprenorphine	
Public clinic	944	—	10	5	3	10	15	7	994	
Private clinic	784	—	—	—	—	—	—	—	784	
Pharmacy	1,250	1,058	483	136	397	59	41	11	3,435	
Correctional setting	176	7	7	2	—	3	—	—	195	
Other	299	5	26	4	2	—	—	—	336	
Not reported(d) 	—	—	224	—	67	—	—	—	291	
Total	3,453	1,070	750	147	402	72	56	18	5,968	
	Buprenorphine/naloxone	
Public clinic	—	—	44	7	44	32	45	24	196	
Private clinic	—	12	—	—	—	—	—	—	12	
Pharmacy	—	3,540	862	841	500	56	66	32	5,897	
Correctional setting	—	80	9	18	57	2	—	1	167	
Other	—	18	34	2	—	—	—	—	54	
Not reported(d)	—	—	603	—	126	—	—	—	729	
Total	—	3,650	1,552	868	601	90	111	57	6,929	
	Total (all pharmacotherapy drugs)	
Public clinic	3,528	—	114	44	84	62	213	37	4,082	
Private clinic	3,131	103	—	—	—	—	—	—	3,234	
Pharmacy	8,142	11,654	3,715	2,828	2,487	567	528	82	30,003	
Correctional setting	1,948	728	34	305	255	5	51	2	3,328	
Other	1,119	91	230	10	11	—	—	—	1,461	
Not reported(d)	—	—	1,023	—	314	—	—	—	1,337	
Total (no.)	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	
	Total (per cent) (all pharmacotherapy drugs)	
Public clinic	19.7	—	2.2	1.4	2.7	9.8	26.9	30.6	9.4	
Private clinic	17.5	0.8	—	—	—	—	—	—	—	
Pharmacy	45.6	92.7	72.6	88.7	78.9	89.4	66.7	67.8	69.1	
Correctional setting	10.9	5.8	0.7	9.6	8.1	0.8	6.4	1.7	7.7	
Other	6.3	0.7	4.5	0.3	0.3	—	—	—	—	
Not reported(d)	—	—	20.0	—	10.0	—	—	—	—	
Total (%)	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
(b)	In New South Wales the category 'Other' includes sites such as hospitals as well as a small number of general practices. 'Other' also includes where the dosing point was not stated. In Queensland the category ‘Other’ was calculated by including the number for all clients who had prescriptions filled at the dosing points and assuming that all other clients had received takeaways, double doses, etc. (not collected from dosing point).
(c)	In New South Wales clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(d)	The ‘Not reported’ row in this table includes pharmacotherapy clients in Queensland and South Australia who had received a takeaway dose prior to the ‘snapshot/specified’ day.
Table A3: Estimated number of pharmacotherapy clients by pharmacotherapy drug type, sex of the client and jurisdiction, Australia on a ’snapshot/specified’ day(a) 2009
Sex	NSW(b)	Vic	Qld	WA	SA	Tas	ACT	NT	Total	Total (%)	
	Methadone	
Male	9,384	5,199	1,598	1,365	1,231	292	372	28	19,469	64.1	
Female	5,031	2,601	1,214	807	724	180	253	18	10,828	35.7	
Not stated	—	56	2	—	—	—	—	—	58	0.2	
Total	14,415	7,856	2,814	2,172	1,955	472	625	46	30,355	100.0	
	Buprenorphine	
Male	2,413	708	455	70	312	40	43	10	4,051	67.1	
Female	1,040	354	294	77	157	36	13	8	1,979	32.8	
Not stated	—	8	1	—	—	—	—	—	9	0.1	
Total	3,453	1,070	750	147	469	76	56	18	6,039	100.0	
	Buprenorphine/naloxone	
Male	—	2,415	1,061	552	487	53	77	33	4,678	66.4	
Female	—	1,209	488	316	240	33	34	24	2,344	33.2	
Not stated	—	26	3	—	—	—	—	—	29	0.4	
Total	—	3,650	1,552	868	727	86	111	57	7,051	100.0	
	Total (all pharmacotherapy drugs)	
Male	11,797	8,322	3,114	1,987	2,030	385	492	71	28,198	64.9	
Female	6,071	4,164	1,996	1,200	1,121	249	300	50	15,151	34.9	
Not stated	—	90	6	—	—	—	—	—	96	0.2	
Total	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
(b)	In New South Wales clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.

Table A4: Estimated number of pharmacotherapy clients by pharmacotherapy drug type, age group of the client and jurisdiction, Australia on a ’snapshot/specified’ day(a) 2009
Age group	NSW(b)	Vic	Qld	WA	SA	Tas	ACT	NT(c)	Total	Total (%)	
	Methadone	
10–19 years or less	46	16	4	3	3	1	5	—	78	0.3	
20–29 years	2,331	1,367	384	397	258	86	136	—	4,959	16.3	
30–39 years	4,997	3,613	1,061	885	697	220	212	—	11,685	38.5	
40–49 years	4,656	2,036	861	583	672	120	200	—	9,128	30.1	
50–59 years	2,260	751	469	291	316	44	69	—	4,200	13.8	
60 years and over	125	73	35	13	9	1	3	—	258	0.8	
Not reported	—	—	—	—	—	—	—	46	—	—	
Total	14,415	7,856	2,814	2,172	1,955	472	625	46	30,355	100.0	
	Buprenorphine	
10–19 years	29	2	3	—	—	1	—	—	35	0.6	
20–29 years	776	186	169	34	72	26	11	—	1,274	21.1	
30–39 years	1,381	492	347	73	168	31	23	—	2,515	41.6	
40–49 years	905	277	164	25	163	16	17	—	1,567	25.9	
50–59 years	335	103	65	14	63	2	5	—	587	9.7	
60 years and over	27	10	2	1	3	0	—	—	43	0.7	
Not reported	—	—	—	—	—	—	—	18	18	0.3	
Total	3,453	1,070	750	147	469	76	56	18	6,039	100.0	
	Buprenorphine/naloxone	
10–19 years	—	7	6	0	6	—	—	—	19	0.3	
20–29 years	—	635	353	178	191	20	26	—	1,403	19.9	
30–39 years	—	1,679	664	394	294	38	44	—	3,113	44.1	
40–49 years	—	946	381	229	173	23	31	—	1,783	25.3	
50–59 years	—	349	138	64	60	4	10	—	625	8.9	
60 years and over	—	34	10	3	3	1	—	—	51	0.7	
Not reported	—	—	—	—	—	—	—	57	57	0.8	
Total	—	3,650	1,552	868	727	86	111	57	7,051	100.0	
	Total (all pharmacotherapy drugs)	
10–19 years	75	25	13	3	9	2	5	—	132	0.3	
20–29 years	3,107	2,188	906	609	521	132	173	—	7,636	17.6	
30–39 years	6,378	5,784	2,072	1,352	1,159	289	279	—	17,313	39.9	
40–49 years	5,561	3,259	1,406	837	1,008	159	248	—	12,478	28.7	
50–59 years	2,595	1,203	672	369	439	50	84	—	5,412	12.5	
60 years and over	152	117	47	17	15	2	3	—	353	0.8	
Not reported	—	—	—	—	—	—	—	121	121	0.3	
Total	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	100.0	
(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients treated through the month of June is reported.
(b)	In New South Wales, clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(c)	The total number of clients reported excludes pharmacotherapy clients in the Northern Territory where data relating to the age group of clients are not reported.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.
Table A5: Estimated number of pharmacotherapy clients by pharmacotherapy drug type, five year age group from age 20 to age 70 of the client and jurisdiction, Australia on a ’snapshot/ specified’ day(a) 2009
Age group	NSW(b)	Vic	Qld	WA	SA	Tas	ACT	NT(c)	Total	Total (%)	
	Methadone	
19 years or less	46	15	4	3	3	1	5	—	77	0.3	
20–24 years	501	251	73	78	65	12	34	—	1,014	3.3	
25–29 years	1,830	1,116	311	319	193	74	102	—	3,945	13.0	
30–34 years	2,404	1,935	519	489	308	108	100	—	5,863	19.3	
35–39 years	2,593	1,679	542	396	389	112	112	—	5,823	19.2	
40–44 years	2,388	1,216	392	290	338	64	100	—	4,788	15.8	
45–49 years	2,268	820	469	293	334	56	100	—	4,340	14.3	
50–54 years	1,618	520	333	217	231	31	57	—	3,007	9.9	
55–59 years	642	231	136	74	85	13	12	—	1,193	3.9	
60–64 years	103	62	29	13	8	1	2	—	218	0.7	
65–69 years	13	9	6	—	1	—	—	—	29	0.1	
70 years and over 	9	2	—	—	—	—	1	—	12	—	
Not reported	—	—	—	—	—	—	—	46	46	—	
Total	14,415	7,856	2,814	2,172	    1,955	472	625	46	30,355	100.0	
	Buprenorphine	
19 years or less	29	2	3	—	—	1	—	—	35	0.6	
20–24 years	188	34	35	6	15	9	2	—	289	4.8	
25–29 years	588	152	134	28	57	17	9	—	985	16.3	
30–34 years	716	264	191	39	77	11	11	—	1,309	21.7	
35–39 years	665	229	156	34	91	20	12	—	1,207	20.0	
40–44 years	535	166	85	18	86	7	9	—	906	15.0	
45–49 years	370	112	79	7	77	9	8	—	662	11.0	
50–54 years	240	71	50	12	49	2	4	—	428	7.1	
55–59 years	95	31	15	2	14	—	1	—	158	2.6	
60–64 years	20	8	2	1	2	—	—	—	33	0.6	
65–69 years	5	1	—	—	1	—	—	—	7	0.1	
70 years and over	2	—	—	—	—	—	—	—	2	—	
Not reported	—	—	—	—	—	—	—	18	—	—	
Total	3,453	1,070	750	147	469	76	56	18	6,039	100.0	
(continued)
Table A5 (continued): Estimated number of pharmacotherapy clients by pharmacotherapy drug type, five year age group from age 20 to age 70 of the client and jurisdiction, Australia on a ’snapshot/ specified’ day(a) 2009
Age group	NSW(b)	Vic	Qld	WA	SA	Tas	ACT	NT(c)	Total	Total (%)	
	Buprenorphine/naloxone	
19 years or less	—	7	6	—	6	—	—	—	19	0.3	
20–24 years	—	117	86	24	73	4	2	—	306	4.3	
25–29 years	—	519	267	154	118	16	24	—	1,098	15.6	
30–34 years	—	899	368	220	139	24	28	—	1,678	23.8	
35–39 years	—	780	296	174	155	14	16	—	1,435	20.4	
40–44 years	—	565	201	127	114	15	16	—	1,038	14.7	
45–49 years	—	381	180	102	59	8	15	—	745	10.6	
50–54 years	—	242	110	46	46	4	7	—	455	6.4	
55–59 years	—	107	28	18	14	—	3	—	170	2.4	
60–64 years	—	29	8	2	3	1	—	—	43	0.6	
65–69 years	—	4	—	1	—	—	—	—	5	0.1	
70 years and over	—	1	2	—	—	—	—	—	3	—	
Not reported	—	—	—	—	—	—	—	57	—	—	
Total	—	3,650	1,552	868	727	86	111	57	7,051	100.0	
	Total (all pharmacotherapy drugs)	
19 years or less	75	25	13	3	9	2	5	—	132	0.3	
20–24 years	689	402	194	108	153	25	38	—	1,609	3.7	
25–29 years	2,418	1,786	712	501	368	107	135	—	6,027	13.9	
30–34 years	3,120	3,097	1,078	748	524	143	139	—	8,849	20.4	
35–39 years	3,258	2,687	994	604	635	146	140	—	8,464	19.5	
40–44 years	2,923	1,946	678	435	538	86	125	—	6,731	15.5	
45–49 years	2,638	1,313	728	402	470	73	123	—	5,747	13.2	
50–54 years	1,858	833	493	275	326	37	68	—	3,890	9.0	
55–59 years	737	370	179	94	113	13	16	—	1,522	3.5	
60–64 years	123	100	39	16	13	2	2	—	295	0.7	
65–69 years	18	14	6	1	2	—	—	—	41	0.1	
70 years and over	11	3	2	—	—	—	1	—	17	—	
Not reported	—	—	—	—	—	—	—	121	—	—	
Total	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	100.0	

(a)	The number of clients on the program on a ‘snapshot/specified’ day in June, except for Western Australia, where the number of clients 	treated through the month of June is reported.
(b)	In New South Wales, clients prescribed buprenorphine/naloxone are counted under ‘Buprenorphine’.
(c)	The total number of clients reported excludes pharmacotherapy clients in the Northern Territory where data relating to the age group of clients are not reported.
Note: Each state and territory uses a different method to collect data on pharmacotherapy prescription and dosing. These differences may result in minor discrepancies if directly comparing one jurisdiction with another jurisdiction.

Table A6 : Total number of pharmacotherapy clients, prescribers and dosing point sites by jurisdiction 2006–2009
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	2009	
	(Number)	
Total number of clients	17,868	12,576	5,116	3,187	3,151	634	792	121	43,445	
Total number of prescribers	528	457	121	92	73	35	36	8	1,350	
Total number of dosing points	709	436	474	247	198	54	28	11	2,157	
	(Mean)	
Clients per prescriber	33.8	27.5	42.3	34.6	43.2	18.1	22.0	15.1	32.2	
Clients per dosing point 	25.2	28.8	10.8	12.9	15.9	11.7	28.3	11.0	20.1	
	2008	
	(Number)	
Total number of clients	17,168	11,821	4,899	2,908	3,052	588	786	125	41,347	
Total number of prescribers	495	529	111	83	74	52	36	13	1,393	
Total number of dosing points	698	431	470	247	203	50	29	15	2,143	
	(Mean)	
Clients per prescriber	34.7	22.3	44.1	35.0	41.2	11.3	21.8	9.6	29.7	
Clients per dosing point	24.6	27.4	10.4	11.8	15.0	11.8	27.1	8.3	19.3	
	2007	
	(Number)	
Total number of clients	16,348	11,051	4,309	2,822	2,559	600	765	114	38,568	
Total number of prescribers	452	493	99	86	74	52	25	14	1,295	
Total number of dosing points	680	425	484	242	215	49	28	12	2,135	
	(Mean)	
Clients per prescriber	36.2	22.4	43.5	32.8	34.6	11.5	30.6	8.1	29.8	
Clients per dosing point	24.0	26.0	8.9	11.7	11.9	12.2	27.3	9.5	18.1	
	2006	
	(Number)	
Total number of clients	16,355	10,736	4,637	2,888	2,517	602	790	134	38,659	
Total number of prescribers	410	463	134	68	65	48	25	7	1,220	
Total number of dosing points	660	413	503	244	175	48	28	10	2,081	
	(Mean)	
Clients per prescribers	39.9	23.2	34.6	42.5	38.7	12.5	31.6	19.1	31.7	
Clients per dosing point	24.8	26.0	9.2	11.8	14.4	12.5	28.2	13.4	18.6	
Note: This table has been derived from Table 2, Table 4 and Table 6 in this bulletin.

References
AIHW (Australian Institute of Health and Welfare) 2007. National Opioid Pharmacotherapy Statistics Annual Data Collection: 2007 Report. AIHW bulletin no.62 cat. no. AUS 104. Canberra: AIHW.
AIHW 2009. National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) 2009 collection data guide. AIHW cat. no. WP 62 Canberra: AIHW.
DoHA (Australian Government Department of Health and Ageing) 2003. National Drug Strategy Clinical Guidelines and Procedures for the Use of Methadone in the Maintenance Treatment of Opioid Dependence. Canberra: Australian Government. 
DoHA 2007. National Pharmacotherapy Policy for People Dependent on Opioids. Canberra: Australian Government.
DoHA 2008. Canberra: Pharmaceutical Benefits Schedule. Viewed 9 February 2010,
<www.pbs.gov.au/html/consumer/search/results?medicine=METHADONE%20HYDROCHLORIDE>.
DoHA 2009.Canberra: Pharmaceutical Benefits Scheme. Expenditure and prescriptions twelve months to 30 June 2009. Viewed 9 February 2010 <http://www.health.gov.au/internet/main/publishing.nsf/Content/pbs-stats-pbexp-jun09>
Lintzeris N, Clark N, Winstock A, Dunlop A, Muhleisen P, Gowling L et al. 2006. National Clinical Guidelines and Procedures for the Use of Buprenorphine in the Treatment of Opioid Dependence, abbreviated version.  Commonwealth of Australia: Viewed 9 February 2010, <http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/buprenorphine-abbrev> 
Ritter A & Chalmers J, 2009. Polygon: the many sides of to the Australian opioid pharmacotherapy maintenance system, ANCD research no. 18, Canberra, Australian National Council on Drugs
The Pharmaceutical Society of Australia July 2005. Self help 0246–2005. Methadone and Buprenorphine. Viewed 9 February 2010, 
<http://ifeelgreat.com.au/fact_cards/SELF%20HELP_Methadone_May2006.pdf> 
Turning Point Alcohol and Drug Centre. Newspoint March 2008. Treating drug users more doctors urgently needed. Viewed 9 February 2010,
<http://www.turningpoint.org.au/library/newspoint/newspoint_0308.pdf> 

Acknowledgments
This report was prepared by Carey Sebbens, Julia Tresidder and Amber Jefferson from the Australian Institute of Health and Welfare (AIHW).
The AIHW would like to acknowledge the work undertaken by members of the NOPSAD Working Group who supplied the 2009 NOPSAD data and provided comment on the draft publication, including:
•	Mr Kieron McGlone and Ms Anne Lawrance (New South Wales—Department of Health) 
•	Mr Roland Jauernig (Victoria—Department of Health)
•	Ms Lynne Biggs (Queensland—Department of Health)
•	Mrs Joy Knight (Western Australia—Department of Health)
•	Mr Colin Brown (South Australia—Department of Health)
•	Mr Andrew Foskett and Mr Brian Stokes (Tasmania—Department of Health and Human Services)
•	Ms Jennifer Taleski and Mr Marty Owen (Australian Capital Territory—ACT Health)
•	Mr Chris Moon (Northern Territory—Department of Health and Community Services).
The AIHW gratefully acknowledges the funding provided for this project by the Australian Government Department of Health and Ageing.
The AIHW would also like to acknowledge the Information Services  and Publishing Uni and the Media Marketing and Communications Unit within the AIHW for their contribution. 

© Australian Institute of Health and Welfare 2010

This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Media and Communications Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601.

This publication is part of the Australian Institute of Health and Welfare’s bulletin series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. 

ISSN 1446 9820
ISBN 978 1 74249 030 4

Suggested citation 
AIHW (Australian Institute of Health and Welfare) 2009. National opioid pharmacotherapy statistics annual data collection: 2009 report. Bulletin no.79. Cat. no. AUS 125. Canberra: AIHW.

Australian Institute of Health and Welfare 
Board Chair
Hon. Peter Collins, AM, QC

Director 
Penny Allbon

Any enquiries about or comments on this publication should be directed to:

Julia Tresidder
Australian Institute of Health and Welfare
GPO Box 570
Canberra ACT 2601
Phone: (02) 6244 1000
Email: julia.tresidder@aihw.gov.au 

Published by the Australian Institute of Health and Welfare