Why opioid dependence treatment is hampered

Stakeholders including a well-known community pharmacist are calling for improvement in the dispensing of opioid treatment

Treatment for opioid dependence is hampered by lack of availability, acceptability and affordability of treatment for affected Australians, say Angelo Pricolo, Harm Reduction Australia and ScriptWise.

A new report, A Better System for Better Outcomes, outlines recommendations from a recent National Medicated Assisted Treatment for Opioid Dependence Summit hosted by the two national organisations.

Mr Pricolo is a former national councillor with the Pharmacy Guild of Australia, has been a community pharmacist for 30 years, and is a strong proponent of harm minimisation measures.

“There are many barriers to treatment, but cost is often the biggest problem for both patients and pharmacists,” he says.

“It means that when you’re trying to engage patients, the cost can push them away.

“Treatment gives people the opportunity to expand their lives in other ways. Their lives don’t remain about getting other drugs, withdrawal and getting sick. People can get back to their jobs, their families and their other interests.”

“We need to seriously consider listing methadone and/or buprenorphine on the mainstream PBS. It will encourage doctors to prescribe, pharmacists to dispense and patients to access treatment.”

Reducing the financial impact of treatment is a key focus of the newly released report, which recommends investigating the development of a nationally subsidised scheme that is funded by the Government.

According to Harm Reduction Co-Founder Annie Madden, there is also strong support for addressing the stigma around treatment to improve access to services.

“The report demonstrates that there is a need to improve training and education for health professionals in this area and increase incentives for pharmacists and GPs to provide treatment,” she says.

“A national workforce strategy would help to increase the number of health professionals providing essential treatment for Australians with opioid dependence.”

ScriptWise Ambassador and Gippsland resident Rustie Lassam, a current methadone consumer, has lived the difficulties associated with the high cost of treatment and lack of providers.

Ms Lassam struggled to find a clinician who would provide medication-assisted treatment and now travels approximately 420km a week to see her current GP and pharmacist.

“There are so few physicians around here that are willing to take on patients with opioid dependence or addiction, it’s a real problem.

“It makes it really hard financially having to travel such a distance when treatment is already so expensive, particularly when you are living on or below the poverty line,” says Ms Lassam.

“The stigma around treating people with methadone is just horrible.

“We are all just people trying to get to work and live our lives. We deserve to be treated like any other patients.”

The recommendations include, among others, that a national workforce strategy be drafted and presented to the COAG Health Council; that a national training program for GPs and pharmacists be developed with key medical peak bodies; that meaningful consumer engagement and participation be promoted at a policy level and prior to and during MATOD treatment; and that that police services instruct all officers to follow standard operating procedures and policies regarding MATOD treatment by not conducting unwarranted patrols, surveillance, or person checks in the vicinity of MATOD premises.

Read the full report here.

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