Opioid pharmacotherapy dosing points

Clients attend a clinic or pharmacy (dosing point sites) regularly to take the dose of their prescribed medication under the supervision of a pharmacist or other health professional.

The National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection provides information on dosing sites providing pharmacotherapy drugs to clients on a snapshot day in June 2017. WA used a snapshot day in May 2017.

For more details about the collection, refer to the Technical notes.

Most dosing points are located in pharmacies

Nationally there were 2,732 dosing points in 2016–17 (see Table D1), a steady increase over the 10 years since 2007–08. Nearly 9 in 10 (89%) were located in pharmacies, which were the most common dosing point sites in all states and territories. These proportions are similar to previous years (see Table S17).

Table D1: Dosing point sites, states and territories, 2016–17
Dosing point sites NSW Vic Qld WA SA Tas ACT NT Total Total (%)

Public clinic

35

12

1

3

2

1

2

56

2.0

Private clinic

12

8

20

0.7

Pharmacy

773

594

493

256

198

61

32

17

2,424

88.7

Correctional facility

2

13

4

2

8

1

1

2

33

1.2

Other

78

33

83

2

1

2

199

7.3

Total

900

640

600

261

209

65

36

21

2,732

100.0

Total (%)

32.9

23.4

22.0

9.6

7.7

2.4

1.3

0.8

100.0

. .

Note:

— Nil or rounded to zero.

See the Technical notes for more information about NSW. NSW and WA correctional dosing points are reported as two sites.

The category 'other' includes hospitals, mobile dosing sites, community health clinics, non‑government organisations, doctors' surgeries and dosing points 'not stated'.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2017 collection. Data table [Table S17].

The proportion of clients taking each drug type varied between dosing points

Clients taking buprenorphine-naloxone were more likely to receive their dose at a pharmacy (91%) than clients taking methadone (70%) or buprenorphine only (59%). Clients who received their pharmacotherapy dose in correctional facilities were more likely to receive methadone (9% of total methadone dosed) than clients taking buprenorphine only (4% of total buprenorphine dosed) or buprenorphine-naloxone only (1% of total buprenorphine-naloxone dosed) (see Figure D1). These proportions have remained similar for about the last 5 years (Table S13).

The proportion of clients dosed with buprenorphine-naloxone may be higher than reported, as clients receiving this treatment in New South Wales are reported as receiving buprenorphine. (Refer to Table S14 for a further breakdown of clients by pharmacotherapy type, dosing points, and state and territory.)

Figure D1: Clients receiving pharmacotherapy on a snapshot day, by pharmacotherapy type and dosing point site, 2017

The grouped vertical bar chart shows that clients taking buprenorphine-naloxone were more likely to receive their dose at a pharmacy (91%25) than clients taking methadone (70%25) or buprenorphine only (59%25).

Note:

NSW reports ‘buprenorphine-naloxone’ as ‘buprenorphine’.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2017 collection. Data table [Table S13].

As with prescriber types, the characteristics of the clients treated at particular dosing point sites are not uniform. Dosing points located in pharmacies treated an older client group (those aged 50 and over) in 2017 than other dosing point sites. The client groups dosed at public clinics and private clinics were similar (Table S29).

All dosing point sites (with the exception of ‘other’ which had an even split) treated more males than females, reflecting the overall proportion of males and females receiving pharmacotherapy treatment. The proportion of male clients ranged from 62% for pharmacy dosing points to 89% for correctional facility dosing points. The proportion of female clients ranged from 11% for correctional facility dosing points to 50% in other dosing points and 38% in pharmacy dosing points. Correctional facility dosing points dosed around 9 male clients for every female client (Table S30).

On a snapshot day in 2017, the large majority of clients dosed at public clinics were prescribed by public prescribers (8 in 10 clients). Likewise, almost all clients dosed at private clinics were dosed by private prescribers (9 in 10). For clients treated at pharmacies, about 3 in 10 were prescribed by public prescribers and about 7 in 10 by private prescribers (Table S31).

Dosing points dosed an average of 17 clients

Private clinics dosed, on average, almost 13 times as many clients as each pharmacy (193 clients per dosing point compared to 15) (see Figure D2). Correctional facilities dosed an average of 100 clients, but this number is inflated as New South Wales and Western Australia report all correctional dosing points as being under 2 sites each, rather than counting individual correctional dosing points. When New South Wales and Western Australian data are excluded, correctional facilities dosed an average of 42 clients across the jurisdictions that supplied data (Table S23).

Figure D2: Clients per dosing point site, on a snapshot day, 2017

The horizontal bar chart shows private clinic dosing points had the highest number of clients per dosing point on average, with 193 clients. Hospital dosing points had the lowest, with 3 clients per dosing point on average.

Note:

NSW and WA correctional dosing points are reported as two sites.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2017 collection. Data table [Table S23].

On a snapshot day in 2017, most (70%) dosing points treated between 1 and 20 clients with only 7% treating more than 50 clients. Thirty–five per cent of dosing points treated 1–5 clients, 18% treated 11–20 clients, and 17% treated 6–10 clients. The pattern of client numbers per dosing point varied greatly across the states and territories (Table S20).

In 2017, the average number of clients per dosing point was 18 (see Figure D3). The average has slowly declined each year since 2011 when it peaked at 21 (Table S21). The Australian Capital Territory had the highest ratio of clients per dosing point (28), while the Northern Territory had the lowest number of clients per dosing point (7) (see Figure D3).

Figure D3: Clients per dosing point site, states and territories, 2013 to 2017

The grouped vertical bar chart shows the Australian Capital Territory had highest average numbers of clients per dosing point (28), between 2013 and 2017 compared to other states and territories.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2017 collection. Data table [Table S21].

Dosing points were located mainly in Major cities

Figure D4 shows the distribution of dosing point sites across the states and territories in 2017. The majority of dosing points were located in Major cities. However, when taking the population into account, there were 12 dosing points per 100,000 population in Very remote areas, compared to 10 dosing points per 100,000 population in Major cities. The rate of dosing points per 100,000 population increased with increasing remoteness in New South Wales and Victoria (Table S18).

Figure D4: Dosing point sites, by Statistical Areas Level 2, 2017

The choropleth map shows the number of dosing point sites per Statistical Area Level 2 across Australia. The map shows the majority of dosing point sites are located along the coastal regions.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2017 collection.