Medication Assisted Treatment for Opioid Dependence (MATOD) pharmacotherapy is prescribed by doctors and some nurse practitioners to treat people with opioid dependence. MATOD pharmacotherapy helps to reduce withdrawal symptoms, control cravings, and block or change the effects of opioids.
The broad goal of the MATOD program is to reduce the health, social and economic harms to individuals and the community from non-medical use, and overuse of opioids.
Pharmacists are essential to the MATOD program as treatment of opioid dependence via the program is generally based on daily supervised dosing at a pharmacy or clinic. Supervised daily MATOD supply by a pharmacist (or nurse) allows patients to be assessed before dosing to maximise their safety and that of the community, and to minimise the risk of toxicity, overdose, misuse, and diversion.
Stigmatisation and discrimination against someone based on their use of alcohol or drugs can impact the individual and their families and can be a barrier to getting help.
The following videos show how discrimination and stigmatisation can affect people with drug and alcohol problems:
The Guidelines for South Australian Pharmacists Dispensing Medication Assisted Treatment for Opioid Dependence (MATOD) are intended to provide the practical knowledge needed by pharmacists to provide a safe and effective MATOD service. The guidelines cover:
They also include useful templates for community pharmacies such as:
IMPORTANT NOTE: Please refer to the current *MATOD Takeaway framework for South Australia which has superseded the previous takeaway framework in the Guidelines above.
*Frequently asked questions on Medication Assisted Treatment for Opioid Dependence (MATOD) Program
The DASSA MATOD Community Pharmacy Program Manager can provide MATOD education, training, and support to all South Australian community pharmacists.
Formal MATOD education and training can be arranged for individuals or groups of pharmacists and intern pharmacists in the form of:
MATOD support can be provided to pharmacists in the form of telephone or email communication, or pharmacy site visits. This includes but is not limited to MATOD queries relating to:
For MATOD education, training or support please contact the DASSA Community Pharmacy MATOD Program Manager on (08) 7425 5000 or email HealthDASSAPharmacyEnquiries@sa.gov.au
The DASSA Community Pharmacy MATOD Program Manager maintains details of all South Australian community pharmacies providing a MATOD service.
Maintaining up to date details of MATOD community pharmacies allows DASSA clinicians and support staff to access current information when seeking to place or transfer clients to a suitable community pharmacy and to assist GPs and clients.
From 1 July 2023 the Commonwealth implemented reforms aimed to increase the accessibility and affordability of MATOD via a nationally consistent program delivered predominantly at Section 90 approved community pharmacies across Australia. Please note that MATOD is commonly referred to as Opioid Dependence Therapy (ODT) by the Commonwealth.
These reforms included listing all ODT medicines on the PBS Section 100 Highly Specialised Drug Program (Community Access) and implementing an ODT Community Pharmacy Program managed by the Pharmacy Programs Administrator (PPA).
For more information pharmacists should refer to:
South Australian pharmacists requiring additional support to best manage PBS MATOD issues and requirements are welcome to contact the DASSA Community Pharmacy MATOD Program Manager on (08) 7425 5000 or email HealthDASSAPharmacyEnquiries@sa.gov.au to discuss.
Long-Acting Injectable Buprenorphine (LAIB), also known as Buprenorphine depot injections (BPN depot), are an alternate option to MATOD pharmacotherapies of methadone oral liquid and sublingual buprenorphine (+/- naloxone).
There are two brands of LAIB available in Australia: Buvidal® and Sublocade®. Sublocade® is available as a monthly injection only, and Buvidal® is available in a range of strengths as a monthly or weekly injection.
LAIB has the following benefits and advantages:
LAIB injections are to be administered by subcutaneous injection only and must never be supplied directly to the client or other third party.
serious harm or death could result if administered intravenously, intra-arterially, intramuscularly or intradermally.
Pharmacists are to make arrangements with prescribers to supply dispensed LAIB products directly to the healthcare practitioner who will be administering the injection.
Ordering of Buvidal® and Sublocade® is restricted as per TGA requirements due to the high risk of harm associated with incorrect use of these products. Community pharmacists wanting LAIB related support, including assistance lifting ordering restrictions to access LAIB products, can email: HealthDASSAPharmacyEnquiries@sa.gov.au.
For clinical advice regarding LAIB, please contact the Drug and Alcohol Clinical Advisory Service (DACAS) on (08) 7087 1742 (24 hours 7 days/week including public holidays).
Temporary pharmacy closures
Disruption of MATOD dosing due temporary closure of community pharmacies poses a serious risk to continuity of treatment for MATOD clients.
All pharmacies should have a contingency plan which includes a viable MATOD continuity of care plan in place at their site. Specifically, all MATOD pharmacies are expected to ensure:
In the event of interruption to MATOD services at your pharmacy, pharmacists should contact DASSA immediately through the Alcohol and Drug Information Service (ADIS) on 1300 13 1340 (8.30 am to 10.00 pm every day).
Pharmacists, MATOD prescribers and DASSA clinicians are encouraged to be proactive and communicate regularly. This collaboration and sharing of information between MATOD pharmacists and clinicians can help to identify potential risks to clients and contribute to best patient care.
It is important that pharmacists contact prescribers to work together and discuss solutions when there is evidence of poor compliance, illicit drug use or drug seeking, other inappropriate behaviours or concerns for the client’s health and wellbeing. This includes:
Pharmacists should immediately report MATOD prescribing errors, dispensing errors or dosing incidents to the prescriber/DASSA clinician and follow all recommendations for actions to be taken in the case of MATOD dosing errors.
DASSA can also provide support and guidance to community pharmacists with concerns including but not limited to complex clients, challenging client behaviours, attendance issues, and dosing errors.
Please contact ADIS on 1300 13 1340 or the DASSA Community Pharmacy MATOD Program Manager on (08) 7425 5000. Alternatively non-urgent queries can be emailed to HealthDASSAPharmacyEnquiries@sa.gov.au
MATOD program, suspected or confirmed diversion incident report
Pharmacists should report all cases of suspected, attempted or confirmed diversion to the prescriber, and written notification of the incident must be provided to the Drugs of Dependence Unit (DDU).
Diversion includes not consuming the dose to the complete satisfaction of the dispensing pharmacist, as well as supplying a take-away dose to another person. Clients are required to consume their medication as prescribed.
Fraudulently altering the prescription is a serious breach. It is considered confirmed diversion and must be reported to the Police in addition to the prescriber and the DDU.
These actions may result in authority restrictions or termination of treatment by the DDU.
Suspected theft or loss of controlled drugs
It is a requirement under the Controlled Substances Act 1984 that theft or loss of drugs or substances subject to abuse/diversion be reported by pharmacists. This includes unaccounted losses.
Further resources:
Pharmacists or pharmacy staff with queries relating to the Community Pharmacy MATOD Program can contact Gary Altobelli (DASSA Community Pharmacy MATOD Program Manager) on (08) 7425 5000 or email HealthDASSAPharmacyEnquiries@sa.gov.au.
Alcohol and Drug Information Service (ADIS) is a confidential telephone information, counselling and referral service for the general public, concerned family and friends, students and health professionals.
Telephone: 1300 13 1340 from 8.30 am to 10.00 pm every day. Interstate callers can contact ADIS on (08) 7087 1743.
The Drug and Alcohol Clinical Advisory Service (DACAS) provides clinical advice for South Australian clinicians, both hospital based and community pharmacists.
Phone (08) 7087 1742 (24 hours 7 days/week including public holidays) or e-mail your enquiry to: HealthDACASEnquiries@sa.gov.au
The Drugs of Dependence Unit is responsible for administering those parts of the Controlled Substances Act 1984 relating to drugs of dependence.
Pharmacists should contact the DDU for queries relating to legislation, MATOD prescribers, authorities for MATOD clients or client take away entitlements if there are concerns.
Phone 1300 652 584, Fax: 1300 658 447, Email: HealthDrugsofDependenceUnit@sa.gov.au
Drug and Alcohol Services SA has a range of information resources, pamphlets, posters, professional and research publications available for download.
