Opioid dependence in general practice
Pharmacotherapy for opioid dependence is usually prescribed in the community by trained general practitioners (GPs) or nurse practitioners. GPs play a key role in preventing, identifying and managing patients with opioid dependence.
The Victorian DHHS Policy for Maintenance Pharmacotherapy for Opioid Dependence outlines that any GP is able to prescribe buprenorphine/naloxone (Suboxone®) for a limited number of patients for the treatment of opioid dependence, without completing formal training. During the COVID-19 pandemic, this limit has been increased from 5 to 30.
A 16 minute video and 4 page guide are available to support GPs with prescribing buprenorphine/naloxone.
Supports for GPs
RACGP Victoria provides free accredited pharmacotherapy training for GPs, and the Area 4 Pharmacotherapy Network offers an array of free support to GPs and Nurse Practitioners who manage patients with opioid dependence.
- Accredited training for GPs
- GP mentoring (peer-based support for GPs)
- Addiction Medicine Specialist support and secondary consultation
- Paid Clinical Placements
- Small Group Learning meetings
- GP education at your clinic
- Whole-of-practice education at your clinic
- Meducate Opioid Stewardship online modules
- Community of Practice events
Contact us at A4PN@semphn.org.au or 0428 785 371 for a brochure outlining the available supports.
Accredited training for GPs
Accredited training is available at RACGP Victoria and provides GPs and Nurse Practitioners with the skills to better manage patients with opioid dependence and the accreditation to prescribe buprenorphine/naloxone for more than five patients, or methadone for any patient. This training is called Medication Assisted Treatment of Opioid Dependence (MATOD) training and consists of two parts:
- Module 1: A two-hour online training, also titled Safer Opioid Prescribing, available here. This training is focused on evidence-based practice and consultation approaches that help prevent, recognise and manage problems arising from opioid prescribing. It can be completed at any time, as a stand-along module or as part of the two-part MATOD training.
- Module 2: Part A (two hour online) and Part B (four hour face-to-face)
In Part A, participants will learn about opioid use disorder and the pharmacology of buprenorphine and methadone. Part B is a four-hour interactive face-to-face session with case based discussions, presented by MATOD specialist GPs.
Module 2: Part A (two hour online) is currently available.
Module 2 Part B (face-to-face) training is currently unavailable due to restrictions on face-to-face training as a result of COVID-19. Online training is under development and will be uploaded to this webpage once available.
Click here to register or contact RACGP Program Coordinator Kerrianne Singleton on vic.events@RACGP.org.au or 8699 0468.
GP Mentoring
Peer-based support and mentoring is available for GPs via phone, email or face-to-face. This may include advice about:
- How to diagnose opioid dependence and initiate a patient on pharmacotherapy
- Writing a buprenorphine/naloxone script and applying for a permit
- How to prepare management plans, making the most of medicare billing
Contact us to connect with your local GP mentor.
Addiction Medicine Specialist support & referral
Support
In addition to the specialist support available 24 hours a day-7 days a week through the Drug and Alcohol Clinical Advisory Service (DACAS), GPs can contact local Addiction Medicine Specialists for access to:
- Mentoring and support
- Secondary consultation
- Shared care
- Telehealth
GPs can also attend free specialist-led Small Group Learning meetings (see below for more details).
Contact us to connect with your local Addiction Medicine Specialist for support.
Referral
Referral to Specialist Pharmacotherapy Services or Addiction Medicine Specialist outpatient services may need to be considered for some complex clients. Referral pathways to these services in southern and eastern metropolitan Melbourne are outlined below.
| Provider | GP referral process | Addiction Medicine Specialist |
| Monash Health – Addiction Medicine Unit | Fax referral letter to 9554 8693 OR Phone 9554 8201 |
Dr David Jacka |
| Alfred Health – SouthCity Clinic | Fax 9525 7369 OR Phone 9525 7399 |
Dr Benny Monheit |
| Eastern Health – Turning Point (Box Hill & Richmond) | Fax referral letter or referral form to 9416 3420 OR Phone 8413 8413 |
Dr Matthew Frei |
| Peninsula Health – Consultation Liaison Addiction Medicine Service | Key contact: Dellie McKenzie
Fax referral letter to 9784 2309 |
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Paid Clinical Placements
Observe an experienced MATOD prescriber for 3.5 hours while being reimbursed for your time! Placements are available on any day of the week and are located throughout our catchment. Contact us to find out more.
Small Group Learning meetings
Small Group Learning meetings are RACGP-accredited peer-based educational sessions facilitated by local Addiction Medicine Specialists and address the specific learning needs of participants. They are designed to support pharmacotherapy prescribers in their practice.
Previous sessions have covered topics such as:
- Codeine rescheduling and SafeScript (real-time prescription monitoring)
- Review of pharmacotherapy best practice (doses, initiating a patient, length of treatment)
- Takeaway doses (recent changes to guidelines, assessing stability, communication between prescriber and pharmacist)
- Complex pharmacotherapy patients (when and where to refer, comorbidities, drug interactions)
- Pain management in pharmacotherapy patients (acute and chronic)
Meetings are held bi-monthly in Box Hill, Bayside and Frankston-Mornington. During COVID-19, meetings are held virtually. Contact us to find out more.
GP education at your clinic:
De-mystifying Opioid Replacement Therapy
Designed for GPs, this session can be delivered to any of your practice staff to increase their understanding of opioid dependence and its management in the general practice setting.
Learning Outcomes:
- Overview of Opioid Replacement Therapy / pharmacotherapy for opioid dependence
- Available Opioid Replacement Therapy agents
- Steps to prescribing buprenorphine/naloxone
- Availability of expert support / mentoring GPs
- Information on clinical handover in the absence of patient’s usual prescriber
RACGP Points
Accredited for 2 Category 2 RACGP QI&CPD Points.
Eastern metropolitan region: Click here to view the flyer and to book your session.
Southern metropolitan region: Click here to view the flyer and to book your sessions.
During COVID-19, sessions are held virtually. Contact A4PN@semphn.org.au for more information.
Whole-of-practice education at your clinic:
Management of Opioid Dependence: Best Practice, Business Model
Upskill your practice team and develop a strategic, efficient and viable business model. In-house training customised to your availability and needs.
Learning Outcomes:
- Management of opioid dependence using a chronic disease framework
- Understanding challenging presentations
- Responding to codeine rescheduling and SafeScript (real-time prescription monitoring)
- Implementing effective systems, policies and practice environment
- Building a treatment team and collaborative partnerships
Presenter
Anastasia Dimitriou, a Practice Manager experienced in managing general practice pharmacotherapy programs.
Accreditation/points
This training has been allocated 4 AAPM CPD points by the Australian Association of Practice Management Ltd (AAPM).
Click here to view the flyer and to book your session.
During COVID-19, sessions are held virtually. Contact A4PN@semphn.org.au for more information.
Meducate Opioid Stewardship online modules
Prescription medicines kill more people than the road toll. This statistic reminds us of how opioid stewardship is now as relevant and as necessary as antibiotic stewardship. This online training identifies three stages in patient care during which opioid prescribing can be an issue:
-Initiation of opioids in acute pain
-Initiation of opioids in chronic pain
-Management of patients already prescribed high dose opioids
Click here to access the free online Meducate Opioid Stewardship modules.
This training module is funded by the Victorian Pharmacotherapy Area-Based Networks.
Community of Practice events
A4PN Community of Practice events are multi-disciplinary educational events with expert speakers, including local Addiction Medicine Specialists, presenting on current topics. These events are a fantastic opportunity for cross-sector networking and continuing professional development.
See the Training & Events page for upcoming Community of Practice events.
During COVID-19, sessions are held virtually.
Contact A4PN@semphn.org.au for more information or sign up to the SEMPHN and EMPHN newsletters to receive details of upcoming events.