Opioid Substitution Therapy in Australia: Past, present, future

December 2018

NCETA staff:
Professor Ann Roche
Mr Roger Nicholas
Dr Jane Fischer
Ms Victoria Kostadinov

Project description: 

Opioid substitution therapy (OST) is used to treat dependence on both illicit opioids (e.g., heroin) and pharmaceutical opioids (e.g., oxycodone, morphine etc.). Over the past three decades the use of OST has saved lives, reduced the spread of blood borne diseases and reduced acquisitive crime. Nevertheless, while OST has made a significant contribution to reducing drug-related harm in Australia there is a substantial gap in the literature about the history of this contribution. There is also no known documentation about the current status of OST in each jurisdiction.

To address these gaps, NCETA is conducting a study to:

  • Document the history of the development of OST in Australia
  • Recognise the contribution that OST, and those who implemented it, has made to public health in Australia
  • Obtain the perspectives of key stakeholders regarding the policy influences on its development
  • Document the current status of OST arrangements on a jurisdictional basis, for example:
    • Who can prescribe
    • Available drugs
    • Limitations on prescribing
    • Regulatory oversight
    • Qualifications / accreditation and training required
    • Client limitations (numbers, severity of problems).
  • Make broad comparisons with international jurisdictions (e.g., Canada, the United Kingdom and Portugal)
  • Identify the likely future directions of OST in Australia.

NCETA’s study comprises three stages:

  1.  A comprehensive literature / desktop policy review will be undertaken, targeting publications which analyse the development of, and current arrangements for, OST provision in Australia.
  2. Key informant telephone/skype/ face-to-face interviews will be conducted with up to 20 relevant individuals from Australia. The interviews will focus on participants’ knowledge about/experiences in developing and implementing OST. Participants’ views will be sought on the historical development of OST, contextual / systemic factors influencing OST development, and future directions in the area.
  3. The findings of the literature / desktop review and key informant interviews will be synthesised and included in a final report that will be made publicly available on the NCETA website.