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What GPs say about prescribing Opioid Agonist Treatment

Recently, South Eastern Sydney Local Health District (SESLHD) Drug & Alcohol (D&A) Service conducted interviews with GPs who prescribe Opioid Agonist Treatment (OAT) for people with a history of opioid dependence. The GPs interviewed have been prescribing between two and 15 years, with each prescribing for 30-40 patients, some of whom were existing patients and others referred specifically for OAT. Read on to learn about their feedback around OAT.

Reasons they decided to prescribe OAT:

I found the work to be very rewarding. Substance use disorder (SUD) disproportionately affects the most vulnerable people in our society and usually comes with underlying psychosocial issues.

I wanted to provide a safer life and even save lives. As a group, they are disadvantaged in so many ways. They are so appreciative of the service my practice provides in a non-judgmental way.  I love being able to provide a complete service for my patients, it gives me great satisfaction.

I prescribe and administer depot buprenorphine, perform the patient review and give them their injection in the same consultation. It is convenient for the patient and it gives me a chance to talk to them about other health concerns.

I was able to witness the improvements to quality of life for those able to access OAT easily without stigma or judgement, and I help manage their primary health care needs, as I know seeking medical care can be a barrier for a lot of patients with SUD. I am able to utilise the (Medicare) chronic disease item numbers for some of my patients.

Integrating the service into their practice:

SUD is a common debilitating chronic disease that affects the patients and families of every GP. It is a chronic disease that should have a treatment protocol in every practice, in the same way a patient with diabetes has well known pathways of care. We integrated the provision of care into our practice the same as for other chronic diseases.

I have a practice nurse, and we are about to dedicate part of our GP practice to be a drug and alcohol clinic.

Having a dispensing pharmacy across the road from my practice who I have a good relationship with, was helpful.

Further information or support required:

I would highly recommend using the fantastic nurses who work as part of the GP Liaison in Alcohol and Drugs (GLAD) team, the Drug & Alcohol Specialist Advisory Service (DASAS) ((02) 9361 – 8006) and/or the Alcohol and Drug Information Service (ADIS) (1800 250 015) helplines.

Whenever I have been able to access support from the local D&A service, it has been extremely helpful and accommodating.

I am in contact with the SESLHD D&A service, which is very helpful and supportive. More information and educational activities would be very helpful.

The University of Sydney, Opioid Treatment Accreditation Course (OTAC), is strongly recommended.