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.

Most dosing points are located in pharmacies

Nationally there were 2,852 dosing points in 2017–18 (Table D1), a steady increase over the 10 years since 2008–09. 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 (Table S17).

Table D1: Dosing point sites, states and territories, 2017–18

Dosing point sites

NSW

Vic

Qld

WA

SA

Tas

ACT

NT

Total

Total (%)

Public clinic

35

11

1

 4

2

1

2

56

2.0

Private clinic

13

8

21

0.7

Pharmacy

803

622

519

269

213

66

33

18

2,543

89.2

Correctional facility

2

13

11

2

8

1

1

2

43

1.4

Other

70

37

81

1

2

1

192

6.7

Total

923

672

630

273

225

71

36

22

2,852

100.0

Total (%)

32.4

23.6

22.1

9.6

7.9

2.5

1.3

0.8

100.0

. .

 

Note:

— Nil or rounded to zero.

  1. Refer to the Technical notes for more information about NSW. NSW and WA correctional dosing points are reported as two sites.
  2. 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) 2018 collection. Data table [Table S17].

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

Most clients received their pharmacotherapy treatment at a pharmacy (72%).

Pharmacies were the most common dosing points for clients receiving methadone (70%) followed by correctional facilities (9%) and private and public clinics (both 8%). For clients who received buprenorphine, 63% dosed at a pharmacy and 13% dosed at a public clinics. For clients whose pharmacotherapy treatment was buprenorphine-naloxone, pharmacies were the most common dosing point (85% of clients) (Figure D1).

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.)

Note: NSW reports both ‘buprenorphine-naloxone’ and ‘buprenorphine’ as ‘buprenorphine’.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2018 collection. Data table [Table S13].

As with prescriber types, the characteristics of the clients treated at particular dosing point sites are not uniform. Compared with other dosing point sites, dosing point sites located in pharmacies continued to treat an older client group. Of clients who received their pharmacotherapy at a pharmacy, the 50 and over age group comprised the highest proportion of clients (35%). Conversely, in correctional facilitates this age group comprised the lowest proportion of clients (10%). The client groups dosed at public clinics and private clinics had similar age groupings (Table S29).

All dosing point sites treated more males than females, reflecting the overall proportion of males and females receiving pharmacotherapy treatment. The proportion of male clients ranged from 63% 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 37% in pharmacy dosing points (Table S30).

On a snapshot day in 2018, 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 prescribed 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 18 clients

Private clinics dosed, on average, around 12 times as many clients as each pharmacy (171 clients per dosing point compared to 14) (Figure D2). Correctional facilities dosed an average of 82 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 remaining jurisdictions that supplied data (Table S23).

Notes:

  1. NSW and WA correctional dosing points are reported as two sites.
  2. 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) 2018 collection. Data table [Table S23].

On a snapshot day in 2018, 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 across the states and territories (Table S20).

In 2018, the average number of clients per dosing point was 18 (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 ratio of clients per dosing point (6) (Figure D3).

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2018 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 2018. The majority of dosing points were located in Major cities. However, when taking the population into account, there were 13 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, Victoria and Queensland (Table S18).

Figure D4: Dosing point sites, by Statistical Areas Level 2, 2018

View larger map.

This legend shows the number of dosing point sites, including: 0, 1, 2, 3 and 4 or more.

Source: National opioid pharmacotherapy statistics annual data (NOPSAD) 2018 collection.