Data collection by states and territories

State and territory governments use different methods to collect data about the clients, prescribers and dosing points associated with the opioid pharmacotherapy system. These methods are driven by differences between the states and territories in relation to legislation, information technology systems and resources. Caution should be taken when comparing one state or territory with another. Information on these differences is detailed in the following tables.

Table T1: Administrative features of the NOPSAD collection in each state and territory
State/territory Administrative features

New South Wales

To enrol a patient on the NSW Opioid Treatment Program (OTP), authorisation from the NSW Ministry of Health is required. A NSW medical practitioner who has not received accreditation as a NSW OTP prescriber may be authorised by the Ministry of Health to prescribe methadone for up to ten (10) patients who are being transferred from an accredited prescriber. Unaccredited medical practitioners cannot initiate patients on methadone. With buprenorphine or buprenorphine-naloxone, unaccredited medical practitioners may be authorised to initiate up to twenty (20) buprenorphine or buprenorphine-naloxone patients. The total number of patients that an unaccredited prescriber may obtain authority to prescribe for, at any one time, is thirty (30) with a maximum of 10 of these patients being for methadone. To participate in the NSW OTP, community pharmacies must register with the Ministry of Health and comply with the protocol for community pharmacy dosing points issued by the Ministry.

Victoria

The Victorian Pharmacotherapy Program is a community-based system of Medical Practitioners, Nurse Practitioners (with relevant notation) and Pharmacists. Permits are issued by the Department of Health under the Drugs, Poisons and Controlled Substances Regulations 2017.

Medically Assisted Treatment for Opioid Dependence (MATOD) training is recommended for all pharmacotherapy practitioners. A practitioner is authorised to prescribe Buprenorphine/Naloxone and Long-Acting Injectable Buprenorphine (LAIB) for up to 10 patients without undergoing MATOD training. Approval from the Department of Health is required for more than 10 patients.

SafeScript, introduced in April 2020, is a mandatory recording system for all General Practitioners and Pharmacists that monitors most drugs of dependence, including all Schedule 8 medicines such as Buprenorphine. 

Queensland

The Queensland Opioid Treatment Program is essentially community based, other than for inpatients in hospitals and correctional facilities.  Prescribers undertake training provided by Queensland Health, and the Department provides approval to commence prescribing on successful completion of the training program. Prescriber training is provided for all pharmacotherapies currently available.

No approval is required for community pharmacies to supply opioid treatment drugs, as this is within the endorsement of registered pharmacists.

Western Australia

The Western Australian pharmacotherapy program is community‑based, other than inpatients in hospitals, prisons and the public clinic. Prescribers attend training provided by the Mental Health Commission (MHC) and the Chief Executive Officer of Health provides authorisation under the Medicines and Poisons Regulations 2016, the legislative instrument. Prescriber training is provided for all pharmacotherapies currently available and includes online training modules for practitioners wishing to prescribe Suboxone® to up to 5 patients or practitioners requiring addition of depot buprenorphine formulations to a current accreditation.

Community pharmacies are authorised to participate in the Community Program for Opioid Pharmacotherapy (CPOP). The Pharmacist with overall responsibility is required to ensure that all pharmacists dosing clients have completed the relevant pharmacist online training module on the MHC website (general pharmacist and depot buprenorphine online training modules are available).

South Australia

All medical practitioners and nurse practitioners (within their scope of practice) can prescribe buprenorphine-naloxone film to treat opioid drug dependence for up to 10 patients, without completing specialised MATOD training. A medical practitioner must become accredited to treat more than 10 patients or to prescribe methadone liquid or buprenorphine as a single agent.  Authorisation under the Controlled Substances Act 1984 must be obtained prior to prescribing any pharmacotherapy to treat opioid drug dependence.

Tasmania

In Tasmania, pharmacotherapy training is provided separately for each pharmacotherapy drug.

Australian Capital Territory

All pharmacists are required to attend training in ‘Treatment of Opioid Dependence for General Practitioners, Pharmacists and Health Professionals’ before they start dosing clients. Canberra Health Services Pharmacy in collaboration with Alcohol & Drug Services conducts this training.

Northern Territory

All opioid substitution treatment prescribers are required to undergo pharmacotherapy training. Accredited prescribers must complete an ‘Application for authority to prescribe a restricted Schedule 8 substance for the treatment of addiction’ for each and submit the form to the Department of Health, Medicines and Poisons Control.  The application information is recorded in the Drug Monitoring System database. The prescriber is not permitted to prescribe until they receive a signed authorisation document. The prescriber must notify Medicines and Poisons Control within 14 days of cessation of treatment.

 

Table T2: Methodological issues of note for the NOPSAD collection in each state and territory
State/territory Methodological issues

National

While the standard snapshot day is set in June of any given year, it varies between states and territories. Despite this variance, it allows the number of clients to be estimated at a single point in time. Data collected for a snapshot day are likely to result in an underestimate of total clients receiving pharmacotherapy within a year. In general, all clients receiving their pharmacotherapy dose in person on the snapshot day are counted.

New South Wales

The NSW Electronic Recording and Reporting of Controlled Drugs (ERRCD) system is used in the administration of the New South Wales Opioid Treatment Program. It replaced the legacy Pharmaceutical Drugs of Addiction System (PHDAS) in September 2016. The ERRCD system is used to record authorisations to prescribe as part of the New South Wales Opioid Treatment Program. It also records client admissions to, and exits from, treatment, as well as details of prescribers and dosing points. For these reasons, the ERRCD system 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 to the program, exits from the program and changes in the status of dosing points cause short-term fluctuations in the database, these flatten out over time.

Clients prescribed buprenorphine-naloxone are counted under ‘buprenorphine’.

Similarly, New South Wales data collection does not differentiate between prescribers who are authorised to prescribe buprenorphine and those authorised to prescribe buprenorphine-naloxone or buprenorphine LAI.

Data on prescribers refer to prescribers who were treating at least 1 client on the snapshot day.

Data on dosing point sites relate to sites that had at least 1 client receiving treatment on the snapshot day.

Client data are reported in New South Wales as at 30 June.

Victoria

Victorian NOPSAD data is collected from 2 sources on the snapshot day of 30 June: a yearly census of Pharmacists and Correctional Facilities, who are requested to report the number and demographics of clients being dosed; and the permit database, Drugs and Poisons Information System (DAPIS), which records information about Medical Practitioners authorised to prescribe pharmacotherapy drugs, as well as demographic information about clients accessing pharmacotherapy treatment.

In 2013, Victoria enhanced data reporting requirements to include detailed age and sex (gender) data by individual pharmacotherapy drug type. Enhancements have also been made to collect Indigenous identity of clients by individual pharmacotherapy drug type. From 2016 to 2018 totals for Indigenous status were reported.

Queensland

Medicine supply data is collected monthly from pharmacists and entered into a central database that the Queensland Health maintains. Data are also collected from administrative ‘admission’ and ‘discharge’ forms. Queensland totals may vary slightly due to these data source differences. For example, a client may be counted as registered and considered in treatment on the snapshot day, but a dosing point might not be able to be assigned because the client was not actually dosing. The total number of prescribers for Queensland includes those from private practice, public clinics, correctional facilities and government medical offices. Client data are reported in Queensland on a snapshot day in June.

Data for Queensland were not available for 2021; refer to the Technical notes for more information.

Western Australia

Data are collected from the monthly reports received from pharmacies and other dosing sites authorised to participate in the Community Program for Opioid Pharmacotherapy (CPOP). The dosing data are entered into the Medicines and Poisons Regulation Branch’s Electronic Recording and Reporting of Controlled Drugs (ERRCD) database. Data are also collected from the ‘Application for authority’, ‘Authority to prescribe’ and ‘Termination of treatment’ forms. The number of clients receiving pharmacotherapy treatment is reported through the month of June.

The total number of prescribers usually includes those treating at least 1 client as at 30 June 2018 in private practice, public clinics and correctional facilities.

In Western Australia, data relating to the Indigenous status of clients is now being collected from new ‘Application to prescribe opioid substitution treatment’ forms but not at the time of renewal for patients continuing in treatment.

Client data are usually reported in Western Australia for the entire month of June. Specifically, pharmacies supply information at the end of June relating to the last dose supplied to the patient for the month of June. If a patient changes pharmacies mid-month, it is possible that they appear on more than 1 pharmacy’s monthly transaction reports and are counted more than once.

Before 2005, Western Australia reported clients over a year.

South Australia

Data are collected from the ‘Authority Application MATOD Program (Medication Assisted Treatment for Opioid Dependence) form, which are entered into a central database system at the Drugs of Dependence Unit (DDU), SA Health. Since 1 November 2020, both the prescribing data and the information from dispensed prescriptions is also collected electronically in real time.

From 2011, data have been collected via a half-yearly survey that pharmacists completed and reported on a snapshot day in June. From 2014, this survey has been conducted annually. Other data are drawn from the DDU database and are about those clients registered for treatment on the snapshot day (but who may not actually receive treatment on that day).

Clients who did not enter a dosing point on the snapshot day are reported as ‘other’ when describing clients by dosing point site.

In South Australia, data relating to prescribers refer to prescribers who were treating at least 1 client on the snapshot day.

Tasmania

Data are collected monthly from all pharmacies participating in the Tasmanian Opioid Pharmacotherapy Program (TOPP), and entered into the Drugs and Poisons Information System (DAPIS). This system is administered by the Pharmaceutical Services Branch (PSB) and manages client registration, dosing activity, dosing sites, authority to prescribe and dispensing information relating to drugs of high potential for harm. The system also makes available limited information to relevant medical practitioners and pharmacists, both within and external to the Department to assist safe treatment of patients requiring drugs that are highly addictive. 

Data from DAPIS are made available for management style reporting from a Qlikview-based intranet dashboard.

Client data in Tasmania are reported from a snapshot for the month of June. However, clients are counted only once—if they change dosing point site during the month, the dosing point site that administered the greater number of doses is attributed the activity.

Data on prescribers refer to prescribers who were treating at least 1 client during the month of June.

Data on dosing points refer to dosing points that had a client receiving treatment during the month of June.

Australian Capital Territory

Client participation data are collected manually via Canberra Health Services, Alcohol and Drug Services’ program spreadsheets, and from Medication Administration Chart (MAC) Sheets which the community pharmacies submit each month. Client participation data are also collected via iDose which is a Canberra Health Service and Justice Health database that contains client dosing information in real time. General practitioner and pharmacy participation data are also collated from the MAC Sheets.

Client data is reported on clients receiving treatment in the Australian Capital Territory on a snapshot day in June.

Northern Territory

Data are generated from the current active authorisations in the Drug Monitoring System database on the snapshot day in June. The data are audited against current Schedule 8 prescription data also within the database.

 

Table T3: Policies and guidelines for opioid pharmacotherapy
State/territory Policies and guidelines

National

National guidelines for medication-assisted treatment of opioid dependence

New South Wales

Full version: NSW Clinical Guidelines: Treatment of Opioid Dependence
Abbreviated: NSW Clinical Guidelines: Treatment of Opioid Dependence - Abbreviated Version

Victoria

Policy for maintenance pharmacotherapy for opioid dependence

Pharmacotherapy policy addendum – Long-acting injectable buprenorphine

Long-acting injectable buprenorphine – brief clinical guidelines

Queensland

Queensland Opioid Treatment Program | Queensland Health

Western Australia

Western Australian Community Program for Opioid Pharmacotherapy (CPOP):  clinical policies and procedures for the use of methadone and buprenorphine in the treatment of opioid dependence—3rd Edition

Clinical Guidelines for the use of depot buprenorphine in Western Australia

MP 0139/20 Medicines Handling Policy for WA Health Service Providers and associated Guideline on continuation of opioid substitution treatment in hospitals

South Australia

GP Program - Medication assisted treatment for opioid dependence

Tasmania

Tasmanian Opioid Pharmacotherapy Policy and Clinical Practice Standards

Australian Capital Territory

Opioid Maintenance Treatment in the ACT: Local Policies and Procedures

Northern Territory

Code of Practice: Schedule 8 Substances

Table T4: History of data reported for the NOPSAD collection, 2005 to 2021

Table T4: History of data reported for the NOPSAD collection, 2005 to 2021 (XLSX 23kB)