In 2019-20, opioid dependence continued to be a public health concern, affecting many people across the community, including those who are prescribed opioids for pain and those who take illicit opioids, such as heroin.

The Area 4 Pharmacotherapy Network (A4PN) works to improve patient access to medication to assist in the treatment of opioid addiction (known as pharmacotherapy) across southern and eastern metropolitan Melbourne.

The Area 4 Pharmacotherapy Network (A4PN) is a program that supports health professionals across Victoria to prevent, identify and manage opioid dependence, and to facilitate the delivery of high-quality evidence-based clinical services including Medication Assisted Treatment of Opioid Dependence (MATOD) in southern and eastern metropolitan Melbourne.

MATOD is an effective evidence-based treatment for opioid dependence. It involves the use of methadone, buprenorphine or buprenorphine/naloxone.

The A4PN is a Department of Health and Human Services (DHHS) funded program that is led by SEMPHN, in partnership with Eastern Melbourne Primary Health Network (EMPHN).

The A4PN works closely with Addiction Medicine Specialists, GPs, Nurse Practitioners and pharmacists to support the community-based pharmacotherapy service.

In 2019-20, A4PN increased learning opportunities for health professionals across the eastern and south eastern metropolitan Melbourne regions.

This included:

• The promotion and support of 31 new prescribers who completed MATOD training and nine new pharmacies accredited to deliver MATOD services
• Four large multi-disciplinary Community of Practice events (two face-to-face and two online webinars) for providers across both regions
• Fourteen peer-group learning sessions for MATOD prescribers in Bayside, Box Hill and the Frankston-Mornington Peninsula region, as well as two pharmacist-specific peer-group learning sessions
• Nine funded clinical placements for new or inexperienced MATOD prescribers
• The funding of Addiction Medicine Specialist services as a workforce development initiative including: mentorship, support and clinical guidance for community prescribers; shared care models of patient management; secondary consultation; and contribution to strategic direction and activities of the A4PN.

Pharmacotherapy service availability during COVID-19

For clients or patients involved in the MATOD program, access to pharmacotherapy providers and receiving medication on a daily basis is essential. COVID-19 was particularly challenging, where restrictions in movement and self-isolation of either the MATOD provider or the patient could significantly impact service availability or the ability for patients to access their medications.

The A4PN team were responsive during this time to ensure pharmacotherapy services remained available. These initiatives included:

• A state-wide working group to undertake COVID-19 MATOD response planning
• Active contribution to the development of state-wide MATOD practice guidelines and recommendations to ensure continued patient access to pharmacotherapy during COVID-19
• Contingency planning, including the establishment of a MATOD provider-buddy systems, the development of a transfer or care toolkit for patients where a provider is incapacitated by COVID-19 and the exploration of options for popup and mobile clinics if required
• Providing support to all MATOD providers in the eastern and south eastern metropolitan Melbourne region, including a risk assessment and management plan for all providers.

For more information on A4PN visit http://a4pn.org.au/

If you or someone you know is struggling with prescription or illicit drug use, help is available. Speak to your GP about options that best suit your needs.

SafeScript is a Victorian Government initiative that enables prescribers and pharmacists to access an up-to-the-minute medicine supply history of certain high-risk medicines – such as opioids for their patient – at the point of consultation.

In April 2020, it became mandatory for prescribers and pharmacists to check SafeScript. More than 28,000 clinicians in Victoria are now accessing the system prior to writing or dispensing prescriptions for a high-risk medicine.

During 2019-20, SEMPHN continued to support the roll out of SafeScript, providing resources and training opportunities to prescribers and pharmacists across the region.

We facilitated 10 face-to-face and online SafeScript training sessions on how to safely prescribe and dispense high-risk medications using SafeScript, and respond to the needs of patients, including how to tackle difficult conversations with patients.

As part of the SafeScript initiative, a General Practitioner Clinical Advisory Service (GPCAS) was established to provide peer-to-peer advice and mentoring for Victorian GPs, offering support with patient issues and safe prescribing relating to high-risk prescription medicines. Local GPs and experienced clinical advisors Dr Jenny Devine and Dr Jamie Pike were appointed members of GPCAS, dedicated to supporting GPs in south east Melbourne.

Since SafeScript went live, more patients are likely to be identified as having a dependence on opioids. SEMPHN continues to support health professionals to be confident in this treatment space in order to make safe and appropriate clinical decisions.

For more information on SafeScript visit www.safescript.vic.gov.au

If you or someone you know is struggling with prescription drug use, help is available. Speak to your GP about options that best suit your needs.