Australian Institute of Health and Welfare (2022) National Opioid Pharmacotherapy Statistics Annual Data collection, AIHW, Australian Government, accessed 18 August 2022.
Australian Institute of Health and Welfare. (2022). National Opioid Pharmacotherapy Statistics Annual Data collection. Retrieved from https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
National Opioid Pharmacotherapy Statistics Annual Data collection. Australian Institute of Health and Welfare, 30 March 2022, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
Australian Institute of Health and Welfare. National Opioid Pharmacotherapy Statistics Annual Data collection [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 Aug. 18]. Available from: https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
Australian Institute of Health and Welfare (AIHW) 2022, National Opioid Pharmacotherapy Statistics Annual Data collection, viewed 18 August 2022, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
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Dependence on opioid drugs (including codeine, oxycodone and heroin) is associated with a range of health and social harms that affect people who use drugs, their family and friends, and the wider community. Opioid pharmacotherapy treatment can help reduce harm by providing regular dosing with a safer, legally obtained, longer-lasting opioid. This can reduce cravings for other opioids, help clients to manage the effects of drug dependence and improve overall quality of life.
The NOPSAD report provides information about clients receiving opioid pharmacotherapy in Australia, as well as health professionals who prescribe opioid pharmacotherapy and dosing points (such as pharmacies) where clients receive treatment.
Opioid drugs are substances that have a similar action to morphine in the brain (ADF 2021). They can be prescription pain medicines (such as codeine and oxycodone) or illicit drugs (such as heroin). These include:
Opioids are often prescribed for the management of strong pain. However, they can produce euphoria and are sometimes used for non-medical reasons. Long-term or non-medical use of opioids can lead to health problems such as drug dependence and overdose (WHO 2021).
Since 1 February 2018, access to all opioid pain medicines has required a prescription in Australia. Prior to this, medicines containing low doses of codeine were available over the counter at pharmacies (ADF 2021). Prescription opioids may also be obtained illicitly.
When people use opioids regularly or over a long period of time, they are at an increased risk of developing opioid drug dependence (ADF 2021). Opioid dependence is characterised by a strong desire to use opioids and loss of control over use.
The International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) (WHO 2019) defines 'dependence syndrome' due to the use of opioids as:
'A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state (Code F11.2).'
Opioid dependence is linked to a range of health and social harms, for both individuals who use opioids and the wider community. These include:
Treatments for opioid use disorders aim to reduce the harms associated with dependence (NSW Ministry of Health 2018). Opioid pharmacotherapy treatment, also known as opioid agonist therapy, is one of the most common treatments used for opioid drug dependence in Australia. Opioid pharmacotherapy involves replacing the opioid drug of dependence with a longer-lasting, medically-prescribed opioid.
Opioid pharmacotherapy can reduce drug cravings and other withdrawal symptoms in clients (Gowing et al. 2014). Pharmacotherapy can also have positive impacts on physical and mental health, social functioning and economic participation, and reduce drug-related crime (Ritter and Chalmers 2009).
Clients can receive pharmacotherapy for dependence on a range of opioids, including illicit drugs (such as heroin) and pharmaceutical opioids (such as codeine and oxycodone) (AIHW 2018).
In Australia, 4 medications are registered as pharmacotherapy treatment for people with opioid dependence (Table INTRO1). Refer to Buprenorphine long-acting injections and the Glossary for more information on opioid pharmacotherapy medications in Australia.
Opioid pharmacotherapy treatment is administered according to the law of the relevant state or territory, and within a framework that includes medical, social and psychological treatment. The Australian Government Department of Health has published National guidelines for medication-assisted treatment of opioid dependence (Gowing et al. 2014). These guidelines provide a broad policy context and framework for states and territories when developing their own policies and guidelines for the medication-assisted treatment of opioid dependence. However, policies differ between states and territories.
Recently, two depot forms of buprenorphine (Buvidal® and Sublocade®) were registered for use in the treatment of opioid dependence across Australia. These long-acting injections (described in this report as buprenorphine LAI) were reported where possible for the first time in the NOPSAD 2020 collection.
While jurisdictional differences in the delivery of buprenorphine LAI do apply, there are potential benefits of this treatment in the context of COVID-19. This is because buprenorphine LAI is injected into the tissue under the skin either weekly or monthly, reducing the need for patients to visit their dosing site on a daily basis.
For more information on the NOPSAD collection, see also:
The National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection is compiled from jurisdictional data and provides information about:
Data are reported on a snapshot day in June each year. The snapshot day varies across jurisdictions, as each state and territory uses a slightly different method to collect data. These methodological differences are primarily due to jurisdictional variations in legislation, client management systems and resources. Caution should be exercised when comparing one jurisdiction to another. In 2021, data for Queensland were unavailable and have not been included in this report.
Since March 2020, a series of measures have been put in place across Australia to reduce the transmission of COVID-19 (Department of Health 2020). These include social distancing and hygiene measures, isolation measures for those with COVID-19 or identified as close contacts, and the shutdown of non-essential businesses, public gatherings and travel. Many of these restrictions continued into 2021, and introduced several challenges for prescribers and people accessing opioid pharmacotherapy treatment including:
In response to these restrictions, jurisdictions made temporary changes to opioid pharmacotherapy treatment guidelines and regulations. The aim was to support flexible treatment delivery and maintain the health and safety of patients and prescribers. While the implementation of these amended guidelines and regulations vary across jurisdictions, changes to pharmacotherapy treatment in the context of COVID-19 have included:
It is not yet known how COVID-19 will impact opioid pharmacotherapy treatment long-term.
ADF (Alcohol and Drug Foundation) (2021) Opioids, ADF website, accessed 3 December 2021.
AIHW (Australian Institute of Health and Welfare) (2018) Opioid harm in Australia: and comparisons between Australia and Canada, AIHW, Australian Government, accessed 6 December 2021.
DoH (Department of Health) (2020a) Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 18 March 2020, Department of Health, accessed 9 December 2021.
Gowing L, Ali R, Dunlop A, Farrell M and Lintzeris N (2014) National guidelines for medication-assisted treatment of opioid dependence, DoH for National Drug Strategy, accessed 3 December 2021.
NSW Ministry of Health (2018) NSW Clinical Guidelines: Treatment of Opioid Dependence 2018, NSW Ministry of Health website, accessed 9 December 2021.
Ritter A and Chalmers J (2009) Polygon: the many sides to the Australian opioid pharmacotherapy maintenance system, ANCD research paper no. 18., Australian National Council on Drugs.
Roxburgh A, Bruno R, Larance B and Burns L (2011) Prescription of opioid analgesics and related harms in Australia, Medical Journal of Australia 195:280–284.
WHO (World Health Organization) (2010) Mental and behavioural disorder due to the use of opioids: dependence syndrome. ICD-10: International statistical classification of diseases and related health problems, accessed 3 December 2021.
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