How Do I Get on a Pharmacotherapy Program in Victoria?
Making An Informed Decision
PAMS can provide information on anything & everything to do with the Victorian Pharmacotherapy Program, including:
- How it works?
- What to expect?
- What type of pharmacotherapy would suit you best?
- Access to service providers (doctors and chemists)
It is best if you contact one of the PAMS staff between 10AM to 6PM, Monday to Friday on our free call telephone number: Ph: 1800 443 844. Please note, this is NOT a free call from a mobile phone, so if you are calling from a mobile phone, please let us know and we can call you straight back as long as you can give us a contact number.
Think Before You Jump! (Some things to consider)
The decision to access a pharmacotherapy program is often made in a state of crisis, in haste, with little thought given to the long term consequences. If you are considering it and reading these words right now, hopefully you have enough time to ask yourself a few things before taking the leap – particularly if you have not been on a pharmacotherapy program in the past.
– Is this the best treatment option at this point in your life and if so, why?
– Are you aware of the alternatives, such as a detox program either at home or as part of a residential program? If you have tried the alternatives and they did not work, ask yourself why.
– Pharmacotherapy usually works best as a long-term commitment. Are you prepared for this? How long do you expect your pharmacotherapy program to last?
– Travel – It is still possible to travel (almost anywhere) when on a program, but it does mean you need to organise things in advance.
– Have you found out how the individual pharmacotherapy drugs work? Do you know which is likely to suit you best?
– Do you know how the program works in Victoria? Are you aware of the commitments involved like visiting a GP at least monthly and a pharmacy every day (in the first few months)?
– Can you afford the dispensing fee (approx. $5 per day) without resorting to illegal means of revenue raising?
– Can you get to a pharmacy every day? Will picking up your daily dose interfere with your employment, family commitments, study etc?
– Is this your decision or do you feel coerced? Is there pressure from family members, friends or partners? Is there threat of incarceration or the removal of children? Is the program part of your parole or CBO conditions? If it’s not your decision this may influence your chances of success.
– Are there service providers (doctor & pharmacist) near where you live and do they have vacancies? This can be a particular problem if you live in a regional/rural area.
– Are you involved in any other type of drug treatment at present? (for example individual counselling). If so have you asked your counsellor what he/she thinks?
– Have I spoken to others on a program? Although everybody’s experience is different, it can be extremely helpful to talk to your peers and ask them how the program works for them.
– Are you informed? If the answer is yes, and you have decided to embark on a pharmacotherapy program, it is time to act.
If you have never been on a program before and want to know what will happen, we have included a step by step guide below: Please note, people who live outside of Victoria might want to contact their local drug user organisation to find out more about the process in other states.
The Process of Getting on a Program – Step by Step
Step 1: Do I need a doctor?
Yes. You are going to need a prescribing doctor, a general practitioner (GP) who is registered to prescribe pharmacotherapies, (not all GP’s are registered). Some registered GP’s do not have any capacity to take on new patients, so this may mean travelling to another area to see a prescriber.
How often do I need to see my doctor?
In the first month, you would be expected to see your pharmacotherapy prescriber approximately three to five times, depending on how quickly you stabilise on a daily dose. Once you are stable on a daily dose of pharmacotherapy, most prescribers in Victoria would expect you to see them monthly to renew your prescription.
How do I find a doctor?
You can get help finding a pharmacotherapy GP in your local area by calling either Direct Line Ph: 1800 888236 or PAMS – Ph: 1800 443 844. These are both freecall numbers except from mobile phones.
Step 2: Do I need to find my own pharmacy?
Yes, this is always a good idea. You are going to need a dispensing pharmacist in your local area, (remember especially when you are in the first 3 months of your program, you will be expected to visit the pharmacy every day to receive your dose under supervision of a pharmacist), so it is important to find a pharmacy that dispenses pharmacotherapies in a location that is easily accessible.
How do I find a pharmacy?
If you have been on a program in the past and you left your last pharmacy owing money or they told you to leave, it is best to call PAMS Freecall Ph: 1800443844 for help to get a new pharmacy. If you have never been on a program before, call Direct Line Freecall Ph: 1800 888236 & they will assist you with locating a pharmacy. If there are none in your area or no vacancies, call PAMS.
Does every pharmacy dispense methadone/buprenorphine?
Not every pharmacy is approved to dispense methadone and buprenorphine, the pharmacy has to be registered and the pharmacist in charge has to have received some basic training in how to run this type of program before they can begin to dispense.
What information does the pharmacist need from me?
Many pharmacists will not take people over the phone and request that you come in for an informal interview. During the interview the pharmacist will explain the following:
- hours of operation,
- the cost of the program
- the basic rules
The pharmacist may ask you to sign a contract. They will also ask you when you plan on starting (having your first dose). If the day you plan to start on the program changes, it is a good idea to call and let the pharmacist know.
Is there anything else I need before I can start?
Yes. You must have a prescription and most often a pass-port sized photo that has the GPs signature on the back. Most pharmacies have the capacity to take pass-port photos and you will need to get these photos taken & take them with you when you see your GP.
Is there a limit to the number of people that can dose at a pharmacy?
Yes. It is important to realise that most pharmacies have a maximum number of pharmacotherapy consumers on their program at any one time, so if you are told there are ‘no vacancies’ at a particular pharmacy, it may well be worth asking if they keep a ‘waiting list’.
Step 3: What do I do next?
You are going to need to visit the GP as soon as possible to get a prescription for either methadone or buprenorphine (Subutex or Suboxone).
How do I know if I need methadone or buprenorphine?
If you do not know what drug will be best for you, your GP should be able to help with this decision. If, after talking to your GP, you are still confused, feel free to contact one of the staff at PAMS and we can walk you through it.
Step 4: Will I get my first dose on the day I see the GP?
Your GP will have to put in a ‘permit application’ to the Victorian Department of Health (Drugs, Poisons and Regulation – DPR) which will need to be approved before the GP can legally provide you with a prescription. The permit application is usually approved on the day that it is submitted, providing that it can be submitted before about 2PM in the afternoon, (DPR close at 4PM).
What else happens at the first appointment?
It is a good idea to have any questions ready to ask your GP, but bear in mind, that he/she is often pretty busy. Your first appointment will likely be taken up with working out the most appropriate starting dose for you, completing, submitting and waiting for the permit application to be approved, writing the first prescription and arranging for your dose to be reviewed at a follow-up appointment.
If I decide to go to a different pharmacy, can I take the script there instead?
No. Your prescription can only be taken to a prearranged pharmacy. In other words, pharmacotherapy prescriptions are not transferable from one pharmacy to the next (even if both pharmacies run the program). The name and address of the pharmacy must be written onto the prescription.
So, my GP has the permit, I have a script in my hand and a certified photo and I know what pharmacy to go to, what next? Now you just need to get yourself to the pharmacy to have your first dose.
HINT: Do not turn up 5 minutes before closing (especially for your first dose), as there is usually a lot to do on the first day. Your pharmacist will need to ensure you have a book where your doses are documented or they may have a computerised dosing system, both of which need to be ‘set up’ and this can take some time.
Is there anything else I need to know or remember?
If you are starting on either type of buprenorphine (Subutex or Suboxone), you must wait at least 8 to 12 hours after the last time you used any other opioids before you have the first dose at the pharmacy.
HINT: You need to be starting to feel the symptoms of opioid withdrawal before you have the first dose. For further information, refer back to the section on ‘drug pharmacology’ or call PAMS.
What do I do if my dose does not ‘hold’ me?
No matter if you are prescribed methadone or buprenorphine, it may take a few days, or even up to a week or more (especially with methadone and if you have been using a lot), to get the right dose.
How do I know if I am on the right dose?
The correct dose should ‘hold’ you for 24 hours without any signs or symptoms of opioid withdrawal.
What do I do if I feel a bit ’out of it’?
If you feel drowsy or ‘out of it’ – do not drive or operate machinery, this may be a sign that your dose could be too high. If this is the case, you need to speak to your prescribing GP and get medical advice as soon as possible. Try to make sure you are not alone overnight & DO NOT DRINK ALCOHOL or take any BENZOS (Valium, Xannex etc).