Summary

Dependence on opioid drugs such as heroin and morphine is associated with a range of health and social problems. Treatment with an opioid pharmacotherapy drug can reduce drug cravings, improve physical and mental health and reduce drug-related crime.

O ver 47,000 Australians received pharmacotherapy treatment for their opioid dependence on a snapshot day in June 2013.

The number of people receiving opioid pharmacotherapy treatment (clients) almost doubled between 1998 (from around 25,000) and 2013, but growth in client numbers slowed in recent years (to less than 1% a year from 2010-2013).

Methadone continues to be the drug most commonly prescribed and the form in which buprenorphine is prescribed is changing.

Around two-thirds (68%) of clients received methadone in 2013, with the proportion remaining relatively stable since 2006. The remaining third (32%) received 1 of 2 forms of buprenorphine. Of these, the proportion receiving buprenorphine only has fallen (from 23% to 13%) while the proportion receiving buprenorphine combined with naloxone has risen (from 6% to 20%) over the same period. Naloxone is added to buprenorphine to deter injection of the medication.

O pioid pharmacotherapy clients are getting older on average.

In 2013, around two-thirds (69%) of clients were aged 30-49, and this proportion has been fairly consistent since 2006. However, from 2006-2013 the proportion of clients aged less than 30 more than halved (from 28% to 11%), and the proportion of clients aged 50 and over more than doubled (from 8% to 19%). These trends suggest an ageing population of clients in pharmacotherapy treatment.

Males and Aboriginal and Torres Strait Islander people are over-represented in pharmacotherapy treatment.

Around two-thirds (65%) of clients receiving pharmacotherapy in June 2013 were male. Where reported, almost 1 in 10 (9%) clients identified as Indigenous. Indigenous people were around 3 times as likely to have received pharmacotherapy treatment as other Australians.

Prescriber numbers have increased, and most work in the private sector.

There were 2,025 prescribers of opioid pharmacotherapy in Australia in 2013, an increase of 15% from 2012. On average, each prescriber treated fewer clients, with the ratio of clients per prescriber falling from 26 in 2012 to 23 in 2013. The majority of prescribers worked in the private sector (82%) and were authorised to prescribe more than 1 type of pharmacotherapy drug (71%).

Most dosing points were located in pharmacies.

Most clients need to attend a dosing point regularly to take their opioid pharmacotherapy drug under supervision. In 2012-13 there were 2,355 dosing point sites in Australia, and 9 in 10  (88%) of these were located in pharmacies.

H eroin is the most common opioid drug leading people to pharmacotherapy treatment.

Clients were about twice as likely to report heroin as an opioid drug of dependence than they were for all opioid pharmaceuticals combined; however this varied by jurisdiction.