Introduction

Dependence on opioid drugs (which include codeine, heroin and oxycodone) is associated with a range of health and social problems that affect individual drug users, their family and friends, and the wider public. Treatment with an opioid pharmacotherapy drug, such as methadone or buprenorphine, can reduce drug cravings (NDARC 2004) and improve physical and mental health and social and economic participation, including a reduction in drug-related crime (Ritter A & Chalmers J 2009).

The National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection provides information on a snapshot day in June 2018 on clients receiving opioid pharmacotherapy treatment, the health professionals prescribing opioid pharmacotherapy drugs, and the dosing points (such as pharmacies) that clients attend to receive their medication.

For more details about the collection, refer to the Technical notes.
Refer to the National Opioid Pharmacotherapy Statistics Annual Data collection data quality statement for more information.

Opioid drugs

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:

  • opiates—drugs naturally derived from the opium poppy, such as codeine and heroin
  • semi-synthetic opiates, such as hydromorphone and oxycodone
  • opioids, such as fentanyl and methadone.

Opioid drugs can be:

  • illicit opioids, predominantly heroin
  • prescription opioids (whether prescribed for the person or obtained illicitly) such as morphine and oxycodone (Roxburgh A et al. 2011 )

From 1 February 2018, all codeine containing analgesics have required a prescription.

Opioid drug dependence

Opioid drug use and dependence is associated with a range of health and social problems including:

  • loss of life through overdose
  • medical and mental health consequences, including transmission of hepatitis C, hepatitis B and HIV
  • social consequences to individuals and their communities, including impact on relationships, employment, education, housing, parenting, finances and crime (NSW Clinical Guidelines: Treatment of Opioid Dependence 2018).

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 pharmacotherapy treatment

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 taken orally.

In Australia, 3 medications are registered for long-term maintenance treatment for opioid-dependent people:

  • methadone
  • buprenorphine
  • buprenorphine-naloxone.

These drugs, known as opioid pharmacotherapies, reduce withdrawal symptoms, the desire to take opioids, and the euphoric effect of taking opioids. Treatment with these drugs 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.

References

DoH (Department of Health) 2014. National guidelines for medication-assisted treatment of opioid dependence. Canberra: DoHA for National Drug Strategy. Viewed 16 January 2019.

NDARC (National Drug and Alcohol Research Centre) 2004. Treatment options for heroin and other opioid dependence: a guide for frontline workers. Canberra: Commonwealth Department of Health and Ageing for the National Drug Strategy. Viewed 16 January 2019.

NSW Clinical Guidelines: Treatment of Opioid Dependence – 2018. Viewed 18 January 2019.

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 16 January 2019.