Pharmacotherapy: Opioid Replacement Treatment (ORT)
Learn how methadone, Suboxone and depot buprenorphine can help people dependent on heroin or opioids create stability in their lives.
People experiencing heroin or other opioid dependence can benefit from a pharmacotherapy treatment called Opioid Substitution/Replacement Treatment/Therapy (OST/ORT). The general public in Australia often know ORT as ‘the methadone program’.
What is pharmacotherapy?
Pharmacotherapy is the use of prescribed medication to assist in the treatment of addiction. Learn more about various forms of pharmacotherapy.
How does Opioid Replacement Therapy (ORT) work?
People in ORT programs are prescribed alternative forms of opioids that provide more stability while the patient works to manage their use. ORT is a harm minimisation treatment with several benefits for the patient:
- Improves safety and minimises overdose risk because patients are receiving medications supervised by medical professionals, rather than sourcing substances of unknown origin.
- Reduces cravings and minimises the painful symptoms of withdrawal when the patient is trying to taper down their use.
- Supports financial stability by creating certainty around costs associated with use.
- Ensures patients are in regular contact with medical providers who can offer ongoing assistance and referral to other helpful programs.
What ORT medications are available in Australia?
Here are the opioid substitution medications available in Australia. Availability varies by region. Each patient has their own needs and will need a doctor’s advice to identify the best option for them.
- Long-acting injectable buprenorphine
- Also known as: LAIB, depot/depot buprenorphine, Sublocade, Buvidal.
- A weekly or monthly injection gradually releases medication to deliver a stable dose over a long time.
- This is a good option for people who struggle to stay on daily dosed-medications — for example, people who find it difficult to maintain a routine, or people who live far away from medical services.
- Also known as: Subutex.
- A sublingual (that is, taken under the tongue) pill or film.
- This medication is now used less frequently than other forms of ORT, but is still sometimes prescribed in special cases such as for pregnant women.
- Sublingual tablet or film
- These tablets combine buprenorphine with naloxone, an opioid inhibitor, to improve stability and reduce overdose risk.
- Syrup available in two forms: Aspen Methadone Syrup and Biodone Forte.
- Effects may last up to 24 hours, longer than heroin and other opioids.
- Biodone Forte is specifically recommended for some patients with concerns around oral or dental health, but is not offered by every dispensary.
How do I get a prescription for pharmacotherapy?
Pharmacotherapy processes vary from state to state. Check the websites below for more information on how to enter the program in your state.
Pharmacotherapy in ACT
To access opioid substitution treatment in the ACT, you’ll first need to be assessed by a medical practitioner with Canberra Health Services.
- Referral: Ask a GP or contact the Alcohol and Drug Service Intake & Helpline on 02 5124 9977.
- For more info:Canberra Health Services — Opioid Treatment Service
Pharmacotherapy in NSW
- Referral: Call the Opioid Treatment Line on 1800 642 428, Monday-Friday: 9:30am-5:00pm.
- For more info:NSW Health: NSW Opioid Treatment Program
Pharmacotherapy in NT
- Referral: Call the Alcohol and Drug Information Service on 1800 131 350.
For more info:NT.GOV.AU: Alcohol and drug rehab services
Pharmacotherapy in QLD
- Referral: Call the Alcohol and Other Drug Service on 1800 177 833.
- For more info:QNADA: Where to get help
Pharmacotherapy in SA
- Referral: Call the Alcohol and Drug Information Service on 1300 131 340 (08 7087 1743 if calling from interstate).
- For more info:SAHealth: Treatment options for alcohol or other drug problems
Pharmacotherapy in VIC
- Referral: Call Directline on 1800 888 236. Select option 2 to be directed to pharmacotherapy services.
- For more info:Victoria Department of Health: Pharmacotherapy (opioid replacement therapy)
Pharmacotherapy in WA
- Referral: Call the Community Pharmacotherapy Program on 08 9219 1913 or 08 9219 1907. Alternatively, you can contact the Alcohol and Other Drug Information Service on 1800 198 024.
- For more info:WA Department of Health: Pharmacotherapy in the community
How much do Opioid Replacement medications cost?
The cost of methadone, Suboxone, and buprenorphine treatment will vary based on the location and dispensing pharmacy, but you can expect to pay $35 to $50 per week for the medications, plus any appointment fees charged by your prescriber.
How long can you be on pharmacotherapy medications?
Opioid-replacement treatment medications like methadone, Suboxone, and long-acting injectable buprenorphine are designed for long-term use. Some patients take ORT medications for a year or two, while others stay on them indefinitely and may keep taking them for decades. The pace and goals of the treatment are based on the individual needs of the patient.
Travelling and pharmacotherapy
If you are travelling or moving and won’t be able to attend your usual prescriber or dispenser, you should make a plan to ensure you can maintain your dose. Speak to your prescriber about what you should do, or get in touch with the pharmacotherapy provider in the state you’ll be travelling to.
It’s important to prepare before you leave for your trip, because some states restrict how prescribers and dispensers can fill interstate prescriptions. Also, most services are busy and may not be able to take on new clients unexpectedly.