Legal and practical requirements before starting MATOD

Observe the legal requirements for prescribing opioids to drug-dependent people. Most jurisdictions have constraints on the prescription of opioids, requiring permits (or authority) for prescribing. Some jurisdictions require clinicians to complete specific training before prescribing any form of MATOD; others require this only for prescribing methadone. Free online training regarding MATOD is available from the Royal Australian College of General Practitioners (RACGP) for general practitioners, specialists and nurse practitioners.

Before prescribing MATOD, see the state and territory educational resources, clinical guidelines and regulations governing prescribing MATOD therapy at the following websites:

The Australian Therapeutic Goods Administration (TGA) website has contacts for state and territory medicines and poisons regulation units that provide advice on interpretation of legal requirements for prescribing.

Note: Before prescribing MATOD, see the state- and territory-based educational resources, clinical guidelines and regulations.

See Practical steps before prescribing medication-assisted treatment of opioid dependence (MATOD) for practical steps required before prescribing MATODVictoria Department of Health, 2021.

Figure 1. Practical steps before prescribing medication-assisted treatment of opioid dependence (MATOD)

Review state and territory guidance on MATOD prescribing.

Consult a clinical advisory service for any clinical queries about dosing and monitoring.

Review real-time prescription monitoring sources to ascertain details of treatment provided by other prescribers.

Obtain a permit or authority from your state or territory Department of Health before writing a prescription.

Identify a pharmacy or clinic that will provide the buprenorphine or methadone.

Clarify the dosing arrangements (for sublingual or oral forms) and costs with the pharmacy and the patient.

Certify a photograph of the patient for identification (needed in some jurisdictions to collect the medication from the pharmacy).

Ensure the patient is not intoxicated at the time of their first dose. For buprenorphine, consider the need to assess for evidence of withdrawal before dosing, to avoid precipitated withdrawal.