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Assessment and induction onto Medication assisted treatment for opioid dependence (MATOD)
Forms
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MATOD — Medical Assessment (PDF 58KB)
This clinical form enables the recording of the assessment of a patient for possible commencement of medication assisted treatment for opioid dependence.
Checklists
- MATOD Initial Medical Assessment Checklist — Accredited Prescriber of methadone and buprenorphine (PDF 480KB) can be used as a checklist of steps to be taken when patients are inducted into medication-assisted treatment with methadone or buprenorphine formulations by accredited prescribers.
Patient agreements
- Methadone and Buprenorphine Programs - Patient Agreement (DOC 29KB). The ‘Essential information for patients commencing or recommencing on maintenance pharmacotherapy’ section must not be altered. Your practice details need to be inserted and the details on the lower half of the form can be modified to fit with your practice requirement.
Community pharmacy
- Community pharmacy vacancy list informs which community pharmacies have vacancies for patients and other details of community pharmacies involved in the program, please ring the Alcohol and Drug Information Service (ADIS) on 1300 13 1340.
- Maintenance Pharmacotherapies - Identification Form can be used for making up an ID card for patients going to a community pharmacy.
Please contact the GP Program Project Officer for copies of the following resources on (08) 7425 5045 or email: HealthDASSAGPProgram@sa.gov.au
- Letter of Introduction of Patient to Pharmacist (PDF 17KB) can be used after you have telephoned the pharmacist about a new patient. It is best to give the pharmacist as much clinical information as possible.
Patient resources
Prescribers can obtain copies of the following handbooks by contacting the GP Program Project Officer on (08) 7425 5045 or email dassa.gpprogam@sa.gov.au.