Buprenorphine opioid drug formulations come in various forms, such as:
- Buprenorphine (Subutex®): Buprenorphine acts in a similar way to methadone, but is longer lasting and may be taken daily or every second or third day. The buprenorphine only product is available as a tablet containing buprenorphine hydrochloride that is administered sublingually (by dissolving under the tongue) (Gowing et al. 2014).
- Buprenorphine-naloxone (Suboxone®): The combination buprenorphine-naloxone product is a sublingual tablet or film containing buprenorphine hydrochloride and naloxone hydrochloride (Gowing et al. 2014). It is recommended that buprenorphine-naloxone should be prescribed in preference to buprenorphine for most clients (Gowing et al. 2014). This is because, when taken as intended by dissolving the tablet or film under the tongue, the combined product acts as if it was buprenorphine alone. However, if the combined product is injected, naloxone can block the effects of buprenorphine and increases opioid withdrawal symptoms. This reduces the risk that those receiving buprenorphine naloxone as a takeaway dose will inject it or sell it to others to inject (Chapleo & Walter 1997; Dunlop 2007; Gowing et al. 2014).
- Buprenorphine long-acting injections (LAI): Buprenorphine LAI is injected into the tissue under the skin either weekly or monthly. Two depot forms of buprenorphine (Buvidal® and Sublocade®) are now registered for use in Australia. Buprenorphine LAI is unlikely to be dispensed at pharmacies as the approved prescriber has to administer, or supervise administration of, the injection.
Client: A person registered as receiving opioid pharmacotherapy treatment on the snapshot day.
Correctional facility prescribers: Prescribers who work in prisons or other correctional services.
Dosing point site: A place at which a client is provided a pharmacotherapy drug. Sites include public and private clinics, pharmacies, correctional facilities, hospitals (admitted patients and outpatients) and other locations such as community health centres and doctors’ surgeries.
Methadone (Methadone Syrup®, Biodone Forte®): A synthetic opioid used to treat heroin and other opioid dependence. It reduces opioid withdrawal symptoms, the desire to take opioids and the euphoric effect when opioids are used. It is taken orally on a daily basis (Gowing et al. 2014).
Prescriber (including registered and authorised prescribers): A prescriber who held an authority to prescribe a pharmacotherapy drug and who has not been recorded as ceasing this authority before the snapshot day. Refer to the Table T1 for information about the counting of prescribers for each state and territory. Each jurisdiction has a registration process through which a general practitioner or medical officer/specialist becomes authorised to prescribe a pharmacotherapy drug. This usually involves attending a training course on prescribing pharmacotherapies and/or passing an exam. Some jurisdictions, namely South Australia, New South Wales, Victoria and the Australian Capital Territory, authorise prescribers who have not had the specified training to prescribe pharmacotherapy drugs. These authorised (non-trained) prescribers are included in the reported total count for registered prescribers.
Prescriber type: The sector (public or private) in which the prescriber is practising when prescribing pharmacotherapy drugs.
Private prescribers: Prescribers who work in organisations that are not controlled by government, such as private general practice clinics.
Public prescribers: Prescribers who work in organisations that are part of government or are government controlled, such as public drug and alcohol clinics and public hospitals.
Schedule 4 drug: Prescription only medicine – substances, the use or supply of which, should be by, or on the order of, persons permitted by State or Territory legislation to prescribe and should be available from a pharmacist on prescription.
Schedule 8 drug: A controlled drug – substances which should be available for use but require restriction of manufacture, supply, distribution, possession and use to reduce use and physical or psychological dependence, and associated harms. Methadone and buprenorphine are examples of Schedule 8 drugs.
Statistical Areas Level 2 (SA2): An SA2 is a geographical classification that is defined by the Australian Bureau of Statistics. SA2s generally comprise 3,000 to 25,000 persons and aim to represent communities that engage both socially and economically (ABS 2016).
Specified or snapshot day: A particular day, usually in June each year, on which clients are counted for the NOPSAD collection. The snapshot day varies between states and territories, but allows the number of clients to be estimated at a single point in time. Refer to Table T2 in the Technical notes for information about the use of the snapshot day for each state and territory.
ABS (Australian Bureau of Statistics) (2016) Statistical Area Level 2 (SA2), ABS, Australian Government, accessed 14 January 2022.
Chapleo C B and Walter D S (1997) The buprenorphine naloxone combination product, Research and Clinical Forums 19(2):55–8.
Dunlop A (2007) From Subutex to Suboxone: the Australian experience, accessed 14 January 2022.
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.