Download a PDF version of COVID-19 Frequently Asked Questions for Opioid Treatment Program Patients

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I am worried that I will not be able to continue to get my opioid treatment during the COVID-19 pandemic?

Opioid treatment is considered an essential service. This means that every effort is being made to make sure you can continue to receive your treatment. This may mean you receive it differently, but the aim is make sure you are able to continue to receive your dose.

The Ministry of Health is working very closely with opioid treatment services to make sure that regardless of what happens to a particular clinic, doctor or pharmacy, there will be other options offered to you. This might include:

  • moving from a clinic to a pharmacy
  • transferring to depot buprenorphine
  • increasing the number of takeaways you can get
  • changing dosing points.

What are my rights when negotiating my treatment during this time?

It is your right to receive medical care that suits your needs. If you are being asked to change your treatment in a way that you don’t like, talk to your doctor about why that doesn’t work for you. Services will do their best to help you and to find the best available option.

But, like a lot of people across Australia receiving medical treatment during the COVID-19 pandemic, some people are going to be asked to consider options that may not feel like their preferred choice. Many health services are having to change the way they provide treatment and care as staff are being redeployed or are in isolation. Health services are also trying minimise people coming into contact with each other. All people in NSW are being asked to make compromises for their community in these extraordinary times in an effort to protect public safety.

Your treatment location

Why is my treatment or dosing point changing?

Like a lot of people across Australia receiving medical treatment during the COVID-19 pandemic, you may find some changes to your care.

Some services may have to close or change the way they operate. As a result, you may need to change dosing points or your doctor.

You would normally have a bit more time to get used to this idea, but because of the nature of the pandemic, you might be asked to move quickly or earlier.

Some clinic hours are changing to spread out the times that patients come for their doses and to help with physical distancing. However this is not possible at every clinic because some nursing and medical staff may not be available if they have been moved to the hospitals to help care for patients with COVID-19.

Despite these changes, it is still your right to ask questions and ask for solutions that might suit you better. The Ministry of Health is working very closely with treatment services to minimise any changes to your routine while also protecting your health and the health of the general public.

There are over 21,000 people on the opioid treatment program in NSW, so making sure everyone gets their regular dose is a big job. But, if we work together as a community, we can make sure everyone gets their dose and stays healthy despite the enormous challenges we’re facing.

Why am I being told to get my dose at a pharmacy?

You may be asked to move to a community pharmacy for dosing. This is because it helps with physical distancing. Because of physical distancing laws, services need to minimise the number of people coming in every day. The larger clinics are trying to transfer people to pharmacies temporarily to reduce the number of people that have to come in every day.

Under normal circumstances, if your prescriber considers your dose is stable and you are ready for the next step in the program, you will graduate to a pharmacy. You would normally have a bit more time to get used to this idea, but because of COVID-19, we are asking you to make this move a little earlier.

What are the benefits of moving to a pharmacy?

One of the benefits of moving from a clinic to a pharmacy is to receive takeaways. It is easier for pharmacies to make up more takeaways because not all clinics have access to pharmacists to make up the number of extra doses.

There are more pharmacies around that offer opioid dosing than there are clinics, so spreading people across various chemists means that if one has to close, there are other options around.

Pharmacies also tend to have longer opening hours, which means people have better options around the time they can come in to pick up.

How am I being assessed as “stable”?

People are usually considered stable on the program after around 1-3 months of taking their dose. This is related to whether your body has adjusted to your dose as well as how the other parts of your life are going. People who are assessed as stable are more likely to receive takeaways.

What if the clinic is making me go to a pharmacy and I now have to pay for my dose?

Moving to a pharmacy does mean you are moving from a free, public health service to a private business. This may mean that you need to pay for your dose at some point.

Talk to your clinic about your concerns if you are worried that you cannot afford treatment. They will work with you to try to find the best solution. If you are experiencing financial hardship, make sure you let your clinic know.

They may offer solutions such as short term payment or reduced payment for a period of time. If you receive benefits, the scheduled increase might help you to afford pharmacy dosing fees. See if you can work together to come up with a solution that works for both of you.

Will I be able to return to the clinic if I have been moved to a pharmacy?

You have a right to ask to return to your public clinic if that is what you prefer. This is something you should talk to your prescriber and clinic/case worker about from the beginning. Some people may find that they like picking up from a pharmacy, but if you are worried about your circumstances and feel the clinic is your preferred option, you should make that clear.

Are some people still going to be able to stay with a clinic?

There are going to be people who are not suitable for pharmacy dosing or for extra takeaways and who still need to be dosed at a clinic. This may be because they have just been released from jail, or they are pregnant, or if they have other physical or mental health needs and it is better that they keep in close contact with their case worker or clinic. If you think this applies to you, talk with your doctor or clinic.

What questions should I be asking my clinic, doctor or pharmacist?

If you’re anxious about not being able to receive your dose, you should talk to your clinic, doctor or pharmacist about their plan to keep you dosed. For example, you can ask them:

  • to provide (extra) takeaways
  • write the prescription to cover a longer period
  • consider changing over to depot buprenorphine
  • ask about other places to pick up from
  • ask if your contact details are up to date
  • to provide you with a prescription for naloxone (Narcan) and to explain how it can be used to reverse an opioid overdose in an emergency.

If you are offered other places to get dosed as part of COVID-19 planning, ask for a written referral, and check whether you will have to pay again if you have already paid for the week. Also ask how they will tell the new location the ‘last dose’ information so you can be dosed straight away.

When speaking to your clinic, doctor or pharmacist, you can also ask them what their COVID-19 plan is if you get sick and need to self-isolate. Ask if they are able to deliver and if they can give you extra takeaways.

Accessing your opioid medicine during physical distancing and isolation due to illness

Can I get (more) takeaways so I can practice better physical distancing?

Your clinic may be able to give you more takeaways during this period to reduce the number of times you have to come to get your medication. If you haven’t received takeaways before and would like them, talk to your doctor. Your doctor will work with you to decide if takeaways are the best and safest option for you, and how many may work for you each week.

If you are prescribed more takeaways, it is important to remember to take your dose exactly as it is prescribed. If your label doesn’t already have the days/dates on them, write them on. It helps keep you organised and stops double-dosing, especially if you are sick and not thinking clearly.

It’s also important to safely store your takeaways out of sight, out of reach and in a locked container. In particular, keep them well away from where children might reach them. Children are at high risk of harm from taking adult medications, especially methadone and buprenorphine. Because of this danger, some clinics may ask you to provide a lock box before you can get takeaways. Talk to your clinic if you are concerned that you cannot afford a lock box. They will work with you to try to find the best solution.

You may be given naloxone (Narcan) with your takeaway dose. That is because there may be a risk of overdose if you inject your dose or double dose, or take your dose at the same time as other prescription medications, alcohol or drugs.

Please take care of your takeaway doses. If you lose them, or if they are stolen, or you take more than one at a time, the chances of getting them replaced are extremely low.

It’s also important that we all work to protect the Opioid Treatment Program. Events like accidental methadone overdoses attract huge media interest and put the program under scrutiny, with local communities objecting to and sometimes even advocating for clinics to be shut. We all need to work to keep the program safe by being careful in these extraordinary times.

I heard that we’re not allowed to go outside without a reason, is getting my dose a valid reason?

Yes – the latest rules from the NSW Government say that obtaining medical care is a reasonable excuse for leaving the house. It is your right to receive medical care even in these extraordinary circumstances, including using public transport to get your dose.

It is still your responsibility to maintain physical distancing as much as possible when travelling and getting your dose. Maintaining distance will help protect you and those around you.

Ask your doctor for an appointment card or a letter saying you need to travel for medical reasons.

If you are being threatened with a fine, refer them to Schedule 1, Number 6 of The Public Health Order 2020, which refers to the medical exemption. Show them documentation proving you have an appointment if you have it. You don’t need to tell them what sort of medical treatment you are getting.

The police have said that I will be fined if I am picking up my dose from a clinic, is this true?

Opioid treatment is considered an essential service so you can continue to go and pick up from wherever you can, provided that you are not unwell.

One of the important things that everyone is being asked to do to prevent the spread of COVID-19 is to practice physical distancing. This means you need to keep a distance of 1.5m from other people. This does not mean that you cannot go into a clinic or pharmacy to be dosed.

Police are able to make sure that people stick to the instructions about physical distancing however they cannot stop you from turning up to a clinic, including taking public transport to get there, provided that you do your bit to keep your distance.

If a police officer says you will be fined for picking up your dose, refer them to Public Health (COVID-19 Restrictions on Gathering and Movement) Order 2020 Schedule 1, Number 6, which says that receiving medical treatment is exempt from the order. Show them documentation proving you have an appointment if you have it.

I am required to self-isolate or have COVID-19 and cannot leave my house, how do I get my dose?

If you are self-isolating, call your dosing point and ask for other options to receive your medication. A range of options may be available depending on your circumstances and your clinic staffing, including:

  • having your dose delivered to you.
  • having your dose and some takeaways delivered to you.
  • having a friend or family member pick up your dose for you. If this is your only option, please be aware that both you and your doctor will need to give permission to anyone else that might be able to pick up for you.

These options require a lot of organisation and resources from the clinic or pharmacy. They will be reserved for people who have a known COVID-19 contact. Make sure you are flexible and patient with your service provider at all times, even if you disagree or are worried about their decisions.

I’m feeling unwell with flu-like symptoms, should I still go to my regular dosing?

No - don't go to your dosing point if you’re feeling unwell with a sore throat, runny nose, shortness of breath, fever or dry cough. It’s best if you call your dosing point and ask for other options to receive your treatment. There are a few options depending on your circumstances.

If you are unsure about the disease, there is a lot of up to date information on the NSW Health website – this information is updated often and is there to help answer some of your questions.

What if I am not able to get takeaway doses and I am unwell?

Services are doing their best to make sure that all people who need opioid treatment are able to get it. Some of the options include:

  • someone could visit you at home to provide supervised dosing
  • finding safe places for you to go so that you can receive your medication
  • having a friend or family member pick up your dose for you.

The best thing to do is to talk with your clinic, chemist or prescriber about what options might be available locally as this might be different for everyone.

My depot buprenorphine (Buvidal® or Sublocade®) injection is due while I am isolating at home due to COVID-19, what should I do?

If your depot is due while you are isolating at home, call your prescriber so they can arrange to give you the injection. This may include waiting a few days or a week, which is possible without discomfort for most doses of buvidal depot bupe.

How do I get my dose if I am in hospital?

If you are in hospital, the hospital will make sure you get your dose. You should let the staff know when you are admitted that you are on the program to give them time to get the details from your dosing point and prescriber.

Getting help

How can I get my dose if I cannot get in contact with my doctor?

If your doctor cannot prescribe because of COVID-19, they will arrange another prescriber for you. If you are unable to reach your doctor, call the Opioid Treatment Line (OTL) 1800 642 428 and they will find you another prescriber.

Keep an eye on when your prescription expires and don’t wait till the last minute to get a new one. This way there will be time for someone on the Opioid Treatment Line to help to find a new prescriber for you if necessary.

How can I get my dose if my dosing point closes?

If your dosing point is closed, call the Opioid Treatment Line (OTL) 1800 642 428 and they will advise you of another place for you to dose.

Opioid treatment clinics are considered an essential service and everyone is working hard to ensure that everyone who is on the program can continue to receive their treatment. Services are doing their best to try to stay open.

If a dosing point has to close due to COVID-19, they will work closely with the Ministry of Health and with local pharmacists and clinics to make sure people can be transferred to a nearby dosing point.

Will there be enough supply of opioid medication?

Yes, the Ministry of Health has been working closely with suppliers and has confirmed that there is enough stock of opioid treatment for several months. It will be regularly reordered.

What will happen if I use heroin or other opioids?

It is important to remember that you might be at risk of overdose if you start using again. If you are considering using other opioids, it is recommended that you get naloxone (Narcan), which will allow people to revive you in case you overdose. It is now available for free from many pharmacies, visit Your Room and NSW Users and AIDS Association (NUAA) for more information.

What happens if I am coming out of prison and want to be dosed?

If you have been in prison for a short time and were on opioid treatment beforehand, you will probably return to your original prescriber.

If you were in for a while or if you have moved to another area, Justice Health will work with LHDs before you are released to get you access to opioid treatment in your new location after your release.

If you leave prison on the weekend, you may have to wait a day for your script and last dose details to get to your dosing point. Services will try to get you your dose as soon as possible. Don’t forget to review the harm reduction information that NUAA offers if you are thinking of using.

If you are released unexpectedly, you will be put on a script by Justice Health that will last for a period of time. You can call the Opioid Treatment Line (OTL) 1800 642 428 and they will give you advice on how to access your dose.

Are the rehabs and detoxes open during the COVID–19 pandemic?

The Ministry of Health is working closely with the treatment services to regularly find out and update what services are available. We recommend you contact Alcohol and Drug Information Service (ADIS) on 1800 250 015 for this information.

Who can I talk to if I feel I am not being heard?

If you need support from a peer or someone to advocate for you with a service provider, please ring NUAA on (02) 8354 7300 or 1800 644 413.

Current as at: Monday 11 October 2021