Community Pharmacy Program
The role of the Community Pharmacy Program is to support the pharmacy profession and its involvement in medication assisted treatment for opioid dependence in South Australia. Its primary aim is to maintain and expand community pharmacy involvement in this program.
- Policies and legal obligations
- Guidelines and resources
- Incident reports
- Training for pharmacists
- Privileged Circular Access
- Electronic transmission of S8 report
- Further information and help
These documents outline the legal responsibilities of pharmacists under the Controlled Substances Act 1984. This includes dispensing of medications, such as methadone/buprenorphine for the treatment or maintenance of drug dependence.
The Controlled Substances Act 1984 and the Controlled Substances (Poisons) Regulations 1996 regulate the supply and prescribing of certain drugs in South Australia. The Act provides pharmacists with certain privileges and responsibilities. It is expected that pharmacists will be aware of their obligations under the Act, and ensure they act lawfully and responsibly at all times.
Supervision of dosing allows assessment of the patient before dosing and minimises the potential harm associated with drug overdose, abuse and diversion. The gradual introduction of non-supervised doses for patients who respond to treatment can be valuable as it can be a reward for treatment progress and improve the quality of the patient's life. This Policy documents the take-away rules for non-supervised administration of methadone and buprenorphine doses.
Patients who have been on the program for 5 or more consecutive years in a community setting are eligible to receive 6 take-aways per weeks (or 1 supervised dose a week). Consideration for one supervised dose per week is subject to approval from the Drugs of Dependence Unit. This policy documents the full criteria and application process for six take-away doses of methadone or Suboxone® film.
Suboxone® (buprenorphine/naloxone) tablets were listed on the PBS in 2006, but are no longer available in Australia because Suboxone® film has replaced it. The inclusion of an opioid antagonist (naloxone) with buprenorphine is intended to make the product less attractive for diversion and injection. Diversion of the single ingredient buprenorphine-only tablet Subutex® is much more common than diversion of Suboxone. Risks of such diversion include injecting related harm to the person on the program, or to a third party. Suboxone® film is available in two strengths: 2/0.5mg and 8/2mg. If the patient is experiencing clinically-significant anxiety about ceasing treatment from a 2mg daily dose, Subutex® (buprenorphine) 0.4mg tablets are available for tapering doses below 2mg. In this situation, the doctor is required to apply to the Drugs of Dependence Unit to amend the Suboxone® film authority prescription for a maximum duration of 6 weeks. This Policy for the provision of buprenorphine only tablets documents the rules for the supply of Suboxone® film and Subutex® tablets.
This policy documents the guidelines when circumstances permit the need for twice daily dosing or split dosing of methadone or buprenorphine.
Validity of interstate prescriptions for the Opioid Substitution Treatment Program in South Australia (PDF 156KB)
This information is to assist South Australian pharmacists to determine the validity of an interstate prescription for the Opioid Substitution treatment Program in South Australia.
See the Drugs of Dependence Unit policies and forms for further information on these and other drugs.
- Guidelines for South Australian Pharmacists Dispensing Medication Assisted Treatment for Opioid Dependence (MATOD) (PDF1300KB)
- Information for pharmacists dispensing or administering suboxone sublingual film (PDF 442KB)
Guidelines in response to serious breaches of drug treatment programs are issued to assist prescribers, pharmacists and other health care workers to classify breaches of program rules and of appropriate action to take to ensure persons in drug treatment programs are treated fairly and uniformly, and provide some protection for health professionals working in the Community Pharmacy Program.
- Guidelines for action to be taken in response to serious breaches (PDF 205KB)
- Incident report (fax return) (PDF 129KB).
Pharmacists are encouraged to update their knowledge about the harm minimisation services offered at pharmacies. The Community Pharmacy Program provides training about medication assisted treatment for opioid dependence to pharmacists, intern pharmacists and others in the pharmacy industry.
The Community Pharmacy Program can arrange training in country areas, if it is difficult for pharmacists outside of Adelaide to attend training.
For further information on training sessions email: HealthDASSAPharmacyEnquiries@sa.gov.au
The SA Health Drugs of Dependence Unit maintains details of persons where the Minister's delegate believes the person is consuming drugs that represents a risk or obtaining drugs by false pretences (eg pseudoephedrine products, schedule 4 or schedule 8 medications). This information may be supplied to medical practitioners, pharmacists, managements of hospitals etc by delegates of the Minister for the purpose of preventing or restricting further supply of these drugs to the named people. It must not be used for any other purpose and it is an offence to communicate this information to other persons except so far as is necessary to prevent or restrict further supplies of drugs. National Privacy Principles require these circulars to be disposed of when no longer required.
Further information on Privileged circular access.
The monthly Schedule 8 report must be forwarded to the Drugs of Dependence Unit, by the seventh day of the following month.
Electronic reports should be emailed to Health.DDReturn@sa.gov.au
Alcohol and Drug Information Service (ADIS)
Alcohol and Drug Information Service (ADIS) is a telephone information, counselling and referral service for the general public, concerned family and friends, students and health professionals. ADIS is staffed by training professionals with experience in the alcohol and other drug field. ADIS also provides information about how to access other DASSA and community-based alcohol and other drug services, including information about available prescribers and pharmacies. A range of information pamphlets, posters and other resources are also available.
Telephone: 1300 13 1340 (South Australian callers only - local call fee)
DASSA publications and resources
Drug and Alcohol Services SA has a range of information resources, pamphlets, posters, professional and research publications available for download.
Drug and Alcohol Clinical Advisory Service (DACAS)
The Drug and Alcohol Clinical Advisory Service (DACAS) provides 24 hours per day 7 days per week clinical advice for South Australian clinicians including both hospital based and community pharmacists.
Telephone: (08) 7087 1742 (24 hours 7 days a week, South Australian callers only - local call fee)
Drugs of Dependence Unit
The Drugs of Dependence Unit is responsible for administering those parts of the Controlled Substances Act 1984, relating to drugs of dependence. This includes the issue of authorisations to permit prescribing or supply of a drug of dependence to treat drug dependence or where treatment exceeds two months for other reasons. The Unit is responsible for the development of policies and guidelines in these areas to complement the functioning of the Act.
Telephone: 1300 652 584 (9.00 am to 5.00 pm Monday to Friday)
Fax: 1300 658 447
Community Pharmacy Program
Pharmacists or pharmacy staff with queries relating to the Community Pharmacy Program can email: HealthDASSAPharmacyEnquiries@sa.gov.au