Australian Institute of Health and Welfare (2021) National Opioid Pharmacotherapy Statistics Annual Data collection, AIHW, Australian Government, accessed 28 November 2021
Australian Institute of Health and Welfare. (2021). National Opioid Pharmacotherapy Statistics Annual Data collection. Retrieved from https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
National Opioid Pharmacotherapy Statistics Annual Data collection. Australian Institute of Health and Welfare, 31 March 2021, https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
Australian Institute of Health and Welfare. National Opioid Pharmacotherapy Statistics Annual Data collection [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Nov. 28]. Available from: https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
Australian Institute of Health and Welfare (AIHW) 2021, National Opioid Pharmacotherapy Statistics Annual Data collection, viewed 28 November 2021, https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
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Dependence on opioid drugs is associated with a range of health and social problems that affect individual drug users, their family and friends and the wider public.
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:
Opioid drugs can be:
Since 1 February 2018, access to all medicines containing codeine has required a prescription.
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).'
Opioid drug use and dependence is associated with a range of health and social impacts including:
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 usually taken orally.
Opioid pharmacotherapy treatments (such as methadone or buprenorphine) can:
In Australia, 4 medications are registered for long-term maintenance treatment for opioid-dependent people:
Opioid pharmacotherapy treatment is administered according to the law of the relevant state or territory, and within a framework that 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 National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection is compiled from jurisdictional data and provides information about:
Data are reported on a snapshot day in June each year. The snapshot day varies across jurisdictions. This is because each state and territory uses a slightly different method to collect data. These are driven by jurisdictional differences, such as legislation, computer systems and resources. These differences may result in minor discrepancies when comparing one jurisdiction to another.
In March 2020, a series of measures (including the shutdown of non-essential businesses, public gatherings and travel) were put in place across Australia to reduce the transmission of COVID-19 (Department of Health 2020). These restrictions introduced several new challenges for prescribers and people accessing opioid pharmacotherapy treatment, including:
In response to these restrictions, jurisdictions have made some temporary changes to opioid pharmacotherapy treatment guidelines and regulations. The aim is to support flexible treatment delivery and maintain the health and safety of patients and prescribers. While the implementation of these amended guidelines and regulations do vary across jurisdictions, changes to pharmacotherapy treatment in the context of COVID-19 have included:
It is not yet known how COVID-19 will impact opioid pharmacotherapy treatment long-term.
Recently, two depot forms of buprenorphine (Buvidal® and Sublocade®) were registered for use in the treatment of opioid dependence across Australia. These long acting injections (described in this report as Buprenorphine LAI) will be reported where possible for the first time in the NOPSAD 2020 collection.
While jurisdictional differences in the delivery of buprenorphine LAI do apply, there are potential benefits of this treatment in the context of COVID-19. This is because buprenorphine LAI is injected into the tissue under the skin either weekly or monthly, reducing the need for patients to visit their dosing site on a daily basis.
DoH (Department of Health) 2014. National guidelines for medication-assisted treatment of opioid dependence. Canberra: DoH for National Drug Strategy. Viewed 18 December 2020.
Health (Department of Health) 2020. Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 18 March 2020. Canberra: DoH. Viewed 9 December 2020.
NSW Clinical Guidelines: Treatment of Opioid Dependence – 2018. PDF Download viewed 18 December 2020.
Ritter A & Chalmers J 2009. Polygon: the many sides to the Australian opioid pharmacotherapy maintenance system. ANCD research paper no. 18. Canberra: Australian National Council on Drugs.
Roxburgh A, Bruno R, Larance B & Burns L 2011. Prescription of opioid analgesics and related harms in Australia. Medical Journal of Australia 195:280–284.
WHO (World Health Organization) 2010. Mental and behavioural disorder due to the use of opioids: dependence syndrome. ICD-10: International statistical classification of diseases and related health problems. Viewed 18 December 2020.
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