​Prescribing and administration of depot buprenorphine

From 21 April 2020, all accredited and non-accredited Opioid Treatment Program prescribers can prescribe and administer the depot buprenorphine medicines, Buvidal® and Sublocade®.

Accredited Opioid Treatment Program prescribers

Any medical practitioner or nurse practitioner who is an accredited Opioid Treatment Program (OTP) prescriber may prescribe depot buprenorphine as part of their patient limit of 200.

Non-accredited prescribers

Medical practitioners who are not accredited OTP prescribers may manage up to 30 opioid agonist treatment patients, including:

• up to 20 patients treated with sublingual buprenorphine or buprenorphine-naloxone, or depot buprenorphine and
• up to 10 patients treated with methadone who have been inducted and referred by an accredited OTP prescriber.

The Ministry will be distributing information about this decision to accredited and non-accredited OTP prescribers, together with links to the (interim) NSW Clinical guidelines for use of depot buprenorphine (Buvidal® and Sublocade®) in the treatment of opioid dependence. Non-accredited prescribers will also be provided with contact details for DASAS and advised to contact DASAS for specialist support and advice.

Registered nurse (RN) administration of depot buprenorphine in community settings

RNs may administer depot buprenorphine injections in a community setting (such as a community pharmacy) provided it is within their scope of practice and:

• the RN does not have any conditions or notations applied to their AHPRA registration that would prevent them administering this injection; and
• the product is prescribed for an individual patient by an authorised medical practitioner or nurse practitioner who is satisfied the RN is trained and competent to administer depot buprenorphine injections; and
• the product is supplied by a pharmacist who has dispensed the product for an individual patient, or is supplied by a medical practitioner or nurse practitioner from their clinic stock, without ever being handled by the patient. Individual patients must never handle depot buprenorphine.

The above considers the requirements of the Poisons and Therapeutic Goods Act 1966, the Poisons and Therapeutic Goods Regulation 2008, as well as the depot buprenorphine clinical guidelines.

Enrolled nurse (EN) administration of depot buprenorphine in private practice settings

ENs may administer depot buprenorphine injections in a community medical practice provided it is within their scope of practice and:

• the EN does not have a notation on their AHPRA registration which advises that they have not completed medication education.
• the product is prescribed for an individual patient by an authorised medical practitioner or nurse practitioner who is satisfied the EN is trained and competent to administer depot buprenorphine injections
• the EN is under the supervision of a medical or nurse practitioner or a registered nurse (as defined by the Nursing and Midwifery Board of Australia Enrolled Nurse Standards for Practice)
• the product is supplied by a pharmacist who has dispensed the product for an individual patient, or is supplied by a medical practitioner or nurse practitioner from their clinic stock, without ever being handled by the patient. Individual patients must never handle depot buprenorphine.

Pharmacist administration of depot buprenorphine in community pharmacy settings

Pharmacists are recommended to review the resources available for the NSW pilot if intending to administer depot buprenorphine and meet the minimum requirements which apply to the pilot.

Pharmacists in NSW may administer depot-buprenorphine as long as it is within their scope of practice and professional competency to administer – pharmacists and proprietors offering this service must ensure that the medicine will be administered safely to the patient and should seek further advice from their indemnity provider prior to commencement.

The PSA summary of the legislation for pharmacist administration of medicines via injection is available for reference. In NSW Pharmacists can administer a schedule 8 medicine such as depot buprenorphine by injection when dispensed on a prescription lawfully issued by a medical practitioner or nurse practitioner.