Depot buprenorphine in Australia during COVID-19
During COVID-19, people receiving treatment for opioid use disorder in Australia faced significant challenges. Over 500,000 Australians access buprenorphine or methadone medication treatment programmes nationally, which usually involves seeing a doctor once a month, and attending a pharmacy several times a week to collect medication, alongside counselling and peer supports. The pandemic lockdown restrictions posed real challenges to access.
In light of this, in April 2020 several addiction peak bodies- including the RACP (Chapter of Addiction Medicine), the RANZCP (Faculty of Addiction Psychiatry), Drug and Alcohol Nurses Australasia (DANA), the Pharmaceutical Society of Australia (PSA), the Australian Injecting and Illicit Drug Users League (AIVL), the Australasian Professional Society for Alcohol and other Drugs (APSAD)- came together to endorse a national clinical guidance document to support adaptations in treatment programmes to ensure individuals did not miss out on essential medication. A key part of this document was the consideration of depot or long-acting medication options that could be delivered monthly or weekly.
In a new article in the Journal of Substance Abuse Treatment*, Deputy Clinical Director Dr Shalini Arunogiri and Prof Nick Lintzeris, Conjoint Professor, Discipline of Addiction Medicine at the University of Sydney and Director and Senior Staff Specialist, Drug and Alcohol Services, South East Sydney Local Health District (SESLHD), discuss depot buprenorphine uptake in Australia in the context of COVID-19.
Depot treatments became available here in Australia just before the pandemic restrictions were imposed. They offered convenience and minimised travel at a time when this was critical.
This led to a significant increase in uptake of depot buprenorphine. Yet, in their article, Dr Arunogiri and Prof Lintzeris found that uptake (in NSW) mainly increased in services that already had experience and confidence delivering it. Turning Point, Langton Centre and several other sites in Australia were part of a multisite clinical trial (DEBUT) in 2019, offering consumers the opportunity to participate in clinical research in evaluating the impact of depot buprenorphine on quality of life.
However, the medication is still relatively new to Australian consumers, prescribers and treatment services meaning that implementation will still take some time before more widespread uptake is seen. Nevertheless, the early data supports the role of depot products for Australians living with opioid use disorder.
*This article is free to access till January 26 2021