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APRIL 7, 2020

COVID19 RESPONSE: Pharmacotherapy Services- Information for prescribers and dispensers.

 

The links below are for advice and clinical guidance related to working in the Medically Assisted Treatment for Opioid Dependence (MATOD) sector during the COVID-19 pandemic.

 

Advice moderates existing MATOD policy for prescribers and dispensers in relation to:

  • Takeaway doses

  • Third party collection

  • Suboxone prescribing caps.

This information is intended to provide guidance and support for increased flexibility in clinical treatment during this time.  This advice was developed by alcohol and other drug experts and the Department of Health and Human Services, and will be supported by ongoing work by the department to identify optimal pathways for vulnerable clients, including pharmacotherapy patients.

Please see the Victorian COVID-19 website for current case definition, guidance and testing recommendations.

If you have any questions in relation to this information, please make contact with your local Pharmacotherapy Area Based Network in the first instance. Alternatively you may submit questions to aod.enquiries@dhhs.vic.gov.au.

Includes patient agreement form 

Includes take away review assessment

Click on links for PDF

Some Helpful Tips for People on Pharmacotherapy -

Methadone and Buprenorphine (Suboxone and Subutex):

Prescriber

Pharmacist

1. DON'T PANIC.

 

2. ​MAKE SURE YOU HAVE A VALID & UP-TO-DATE PRESRIPTION(S) for ALL YOUR MEDICATIONS.

If you have a scheduled appointment with your doctor, please do not miss it*

Check if this appointment is face to face or via Telehealth.  

If you are unwell or in self-isolation, call your medical clinic and follow their advice

*Prescribers are in overly high demand and it will be hard to book another appointment.

3. ASK YOUR PRESCRIBER (ie. doctor) FOR A LONGER PRESCRIPTION.

(pharmacotherapy scripts can be written for up to 6 months at a time)

How will it help?  This will mean you don't have to go to the clinic for a longer period of time = Less mixing with others and reduced risk to all BUT there may well be follow-ups during this period via Telehealth

 

4. ASK YOUR PRESCRIBER FOR AS MANY TAKE-AWAY DOSES AS POSSIBLE.

Ask your prescriber to give you as many take-away doses, (TADs) as they feel comfortable with.

See new interim COVID-19 take away policy

How will it help? More take aways will mean less visits to the pharmacy, less mixing with other people, a reduced need to leave your house etc.

If your prescriber is happy to give you more than 4 TADs p/w (methadone) or more than 6 TADs p/w (Suboxone) please make sure your prescriber speaks with your dosing pharmacy so you don't have problems picking them up.

 

5. DO NOT MISS DOSES! If you miss 4 doses in a row of either methadone or buprenorphine (Suboxone/Subutex), your pharmacy cannot dose you. If your prescriber is not available, it might be very hard to find another one, especially in time to prevent opioid withdrawal symptoms.

6. ASK YOUR PHARMACIST WHAT THEIR PLAN IS FOR DOSING PEOPLE IF THEY MUST CLOSE FOR ANY PERIOD OF TIME DURING THIS COVID19 PANDEMIC.

Pharmacies have all been asked to put a plan in place in case they need to close and to ensure continuity of dosing for pharmacotherapy patients

6. GIVE YOUR PHARMACY YOUR UP-TO-DATE CONTACT DETAILS AND MAKE SURE YOU HAVE THEIRS. ie. PHONE NUMBER, ADDRESS ETC  and also that your pharmacist has a colour photograph of you on file.

How does this help?  It’s a good idea to store the pharmacy phone number in your phone contact list so you will know if they try to contact you. If the computer goes down due to network overuse, theyll have a photo of you to dose you manually.

7. ASK THE PHARMACY IF THE DOSING HOURS HAVE CHANGED. (e.g. many pharmacies are closing earlier due to the additional amount of work they are doing to keep things clean.

8. IF (for any reason) YOU ARE IN 'SELF ISOLATION' AND YOU NEED TO GO TO THE PHARMACY TO PICK UP YOUR DOSE, MAKE SURE YOU:

  1. call the pharmacist to let them know you are in self isolation but need to pick up your dose

  2. understand that you may need to organise a specific time to dose or pick up take aways

  3. wear a face mask to protect others, (just in case you are contagious- you may have the virus and feel fine but it may KILL someone else who is more vulnerable) 

  4. Call the COVID19 Coronavirus hotline on 1800 675 389 for additional information

 

 

 

 

INFO ON METHADONE take-away dose (TAD) BOTTLES

Ideally a new bottle should be given to each person for each dose, but bottles can be costly-to the environment and financially!- If you ARE permitted to RE-USE YOUR OWN TAD bottle/s - KEEP THEM CLEAN.

  • TAD bottles should be washed out with warm soapy water, thoroughly rinsed and left to air-dry.

  • TAD bottles should only be brought back to the pharmacy on the day you need your TAD.

  • Do not use your TAD bottles for anything other than methadone.

  • Before you take your dose, pour the methadone into a glass and drink it straight away. This will help to keep the bottle clean from saliva and germs.

 

Storage of TADs (methadone and buprenorphine)

  • Methadone TADs should be kept in a safe or a locked cabinet, (e.g. bedside table, filing cabinet, desk drawer etc), well out of the way of children or others.

  • Methadone does not need to be kept refrigerated unless it is diluted with cordial, (pharmacists are advised to use water only to dilute TAD doses but some still use cordial- ask for no cordial-they will last longer in more conditions.

Next Steps

The PAMS Service, the Victorian methadone/buprenorphine prescribers and pharmacists and the Victorian Department of Health and Human Services, (DHHS) are all working hard to ensure everyone on the program will continue to get their doses through this pandemic.

 

As soon as we know more, we will let you know via this website.

 

Other Online Resources and Information:

Additional information can be found at the Victorian DHHS and the Department of Health and Ageing websites. There is an over supply of information out there- both correct and incorrect. DO YOUR RESEARCH and again- DON'T PANIC. 

 

 

Follow these links:

 

https://www.dhhs.vic.gov.au/coronavirus

 

https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-novel-coronavirus.htm

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