Opioid pharmacotherapy in the community
What are opioids?
Opioids are derived from a substance produced by the opium poppy which, when dried, is known as opium. These types of drugs are very strong pain relievers.
Heroin is a highly addictive, illegal opioid. It is made by adding a chemical to another type of opioid, usually morphine or codeine.
Opioids can be prescribed for pain management or addiction treatment.
What are opioid pharmacotherapies and why are they used?
Opioid pharmacotherapies are replacement treatments that are used to reduce the demand for drugs such as heroin and other opioids.
The goal of replacement treatments (also known as opioid substitution treatment) is to stabilise the lives of drug dependent persons, reduce their drug use, the harm associated with it, and the crime often related to it.
The pharmacotherapy medications available are:
Methadone is a synthetic (artificially manufactured) opioid. It is often used as a substitute for heroin.
It is different to heroin because:
- the effects last longer (up to 24 hours)
- it is an oral medication.
There are 2 preparations available in Australia for daily opioid replacement:
- Methadone Syrup® 5mg/mL
- Biodone Forte Solution® 5mg/mL.
Buprenorphine is a derivative of another opioid, morphine. It works by diminishing cravings for heroin and other opioids. It also prevents or alleviates symptoms of withdrawal in dependent heroin users.
There are 2 products available in Australia for use:
- Subutex® sublingual tablets containing buprenorphine hydrochloride in strengths of 0.4mg, 2mg or 8mg
- Suboxone® sublingual tablets and film contain buprenorphine hydrochloride and naloxone hydrochloride in a ratio of 4:1 in 2mg and 8mg. These contain buprenorphine hydrochloride and naloxone hydrochloride in a ratio of 4:1.
What is the Community Program for Opioid Pharmacotherapy (CPOP)?
The Community Program for Opioid Pharmacotherapy (CPOP) provides replacement treatment for opioid dependence, including heroin dependence.
While in treatment, you are expected to attend a nominated pharmacy on a daily basis to receive a supervised dose of opioid pharmacotherapy which your doctor has prescribed.
When you have been in treatment for more than 6 months and are considered stable, the pharmacist may be able to dispense you with a dose which can be taken home. This is called a 'takeaway' dose and can only be given to you the day before the due dose.
CPOP is a partnership between government and community service providers. The program has adopted shared care approach with most opioid substitution treatment being provided by GPs and community pharmacists.
How can I access treatment in the CPOP?
Initial contact with CPOP can be made by contacting:
How do I find an authorised CPOP doctor in my area?
To find an authorised CPOP prescriber, contact Community Pharmacotherapy Program (CPP) on 9219 1907 or 9219 1913.
Why have my weekly takeaway doses been reduced?
Speak to your doctor about why your takeaway doses have been reduced.
There is a set policy around the provision of takeaway doses under the CPOP. Your doctor decides the number of takeaway doses you can receive in a week. To grant takeaway doses, your doctor must take into account your:
- working arrangements
- family matters.
To prescribe takeaway doses additional to those outlined in the policy, your doctor must apply to the CPOP Clinical Review Committee (CRC).
How do I find a new dosing pharmacy?
The Community Pharmacotherapy Program (external site) will be able to assist with names of pharmacies who are participating in the CPOP who are able to take on a new patient.
The program can be contacted on 9219 1907 or 9219 1913.
What is the Register of Notified Drug Addicts?
The Register of Notified Drug Addicts is a list of all people within WA who have had their names added to a list. Your name can be added to the list in 2 ways.
- A medical practitioner may notify the Department of Health if they become aware or suspect that you are addicted to drugs (strong pain medicine in Schedule 8 or illicit substances in Schedule 9).
- Treatment for drug dependence in the Community Program for Opioid Pharmacotherapy (CPOP). You sign a statement that acknowledges you are aware that your name will be included on the Register.
Being on the Register means that before your doctor can prescribe a Schedule 8 medicine (strong pain medicine) they will need to make an application to the Department of Health before prescribing these for you.
See drugs of dependence for more information.
Medicines and Poisons Regulation Branch
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.