overview of non- medical use of pharmaceutical opioids in

Overview of non-medical use of

pharmaceutical opioids in Australia

27 - 28 March 2018, QT Hotel Canberra

Marissa Veld

Introduction• What are pharmaceutical opioids? Defining non-medical use

– Common pharmaceutical opioids, what is misuse, impacts of misuse– International context and trends in deaths

• Consumption patterns– National wastewater analysis and Pharmaceutical Benefits Scheme

data– Illicit and non-medical use (National Drug Strategy Household Survey)

• Harms and Treatment– Ambulance attendances and Hospitalisations – Treatment (Alcohol and Other Drug Treatment Services)

• Policy responses• Breaking down the data silos

What are pharmaceutical opioids?

• Pharmaceutical opioids are used to treat acute and chronic pain (including cancer and post operative) and opioid (including heroin) dependence

• Examples include oxycodone, codeine, fentanyl, methadone.

• The immediate effects include relief from pain and euphoria (feeling of wellbeing).

How do we define non-medical use?

Terminology

• The non-medical use of pharmaceuticals includes the use of over-the-counter or prescription-only drugs for non-therapeutic purposes, or prescription only drugs without a valid prescription

• Misuse includes non-medical use and the use of pharmaceuticals for genuine medical purposes:– without a valid prescription– prescribed in excessive quantities or frequencies– due to a drug dependence that has developed following medical

treatment

Can be difficult to determine from data

Impacts of non-medical use

Short term effects

• Constipation• Nausea• Sedation• Vomiting• Dizziness• Slowed breathing• Overdose (fatal and non-

fatal)

Long term effects

• Tolerance and dependence

• Decreased cognitive function

• Occlusion of blood vessels • Gastro-intestinal bleeding• Mental health problems

including depression

How big is the problem of non-medical use of opioids?

Source: 2016 National Drug Strategy Household Survey

Significant harms in the USA• In the USA, in 2015, almost 22,000 deaths—or about 62 deaths each day—

involved prescription opioids (including methadone and synthetic opioids, such as fentanyl and tramadol)

• In the 12 months between 2014 and 2015, the rate of deaths involving opioids increased 15.6% to 10.4 per 100,000 population

Australians appear less aware of the harms• 28% of Australians aged 14 and over perceived the non-medical use of

pharmaceuticals to be acceptable (up from from 23% in 2013)• This is higher than approval of the regular use of tobacco (15.7%) and cannabis

(14.5%).

Sources: Centers for Disease Control (2016) and Rudd et al 2016

Rate of drug induced deaths rising

Rate of drug-induced deaths for selected drug classes, 1999-2016

Source: ABS Cause of Death 2016

0

1

2

3

4

5

6

7

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Rate per 100,000

Opioids Depressants Anti-depressants Non-Opioid Analgesics

Defined as deaths that can be directly attributable to drug use, as determined by toxicology and pathology reports

Opioid related deaths

Number of drug-induced deaths from opioids and heroin, 1999-2016

0

100

200

300

400

500

600

700

800

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

NumberMethadone Other opioids Other synthetic narcotics Heroin

Source: ABS Cause of Death 2016

In 2016, there were 550 drug-induced deaths from ‘other opioids’ (includes prescription painkillers such as oxycodone, morphine and codeine – but excludes heroin).

Trends in consumption • National wastewater analysis

shows consumption of oxycodone and fentanyl (licit and illicit) exceeds heroin consumption

• 11.12 million opioid prescriptions were dispensed under the PBS in 2014–15up 24% in 5 years.

• Rates between 2010-11 and 2014-15 increased for– Oxycodone (up 58%)– Buprenorphine (up 39%)– Fentanyl (up 13%)

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

2010-11 2011-12 2012-13 2013-14 2014-15

Rate per 100,000 Oxycodone Codeine Morphine

Buprenorphine Methadone Tramadol

Fentanyl

Rate of PBS prescriptions for selected opioids, 2010-11 to 2014-15

Source: AIHW analysis of the Pharmaceutical Benefits Scheme (PBS)

Self reported non-medical use2016 National Drug Strategy Household Survey - Self reported information on the use of pharmaceutical opioids for non-medical purposes

• 3.6% Australians had misused painkillers / opioids in the previous 12 months

• 3 in 4 (75%) of recent painkillers/ opioids misusers had misused an over the counter codeine product

• Non-medical use of painkillers / opioids was:– Higher for people in their 40s (4.5%); and users were generally older than

users of other illicit drugs– More prevalent for people living with mental illness (29%) or chronic pain

(16%)– Purchased over the counter at a pharmacy by around half (52%) of users – Reported by around 1 in 10 (10.6%) that they could not stop or cut down

if they wanted to

Frequency of non-medical use

Source: 2016 National Drug Strategy Household Survey

0

5

10

15

20

25

30

35

40

45

Pain-killers/ opioids Tranquillisers/sleeping pills Cannabis Meth/Amphetamines Cocaine

Percent

Male Female Persons

Daily or weekly use of selected drugs by sex, 2016

Of Australians who had misused pain-killers / opioids in the previous 12 months, 30% reporting do so daily or weekly, and use was higher for females (33%)

Harms from pharmaceutical opioids increasing

Ambulance data• No national data available• Victorian data show that of

the pharmaceutical-related ambulance attendances, 1 in 10 (11%) involved opioid analgesics.

• 4% were related to opioid pharmacotherapy drugs, like methadone and buprenorphine

Hospitals separations• with a principal diagnosis of

substance use disorder or harm due to opioids (including heroin, opium, morphine, and methadone) is increasing

• In 2015–16, the rate was 37.1 per 100,000 population (or 6.6% of drug-related separations) up from 33.0 per 100,000 population in 2011–12.Source: National Hospitals Morbidity Dataset 2015-16 Source: Alcohol and Other Drugs Statistics, Turning Point

Treatment for pharmaceutical opioids Alcohol and Other Drug Treatment Services (AODTS)

• Increase in the proportion of treatment episodes for most pharmaceutical opioids

• Of treatment episodes for pharmaceuticals over the last 10 years:– Oxycodone increased 3.8 times– Codeine increased 2.4 times– Other opioids (fentanyl and

tramadol) increased 5.2 times

Proportion of closed treatment episodes for selected pharmaceutical drugs of concern, 2006-07 to 2015-16

0

5

10

15

20

25

30Per cent Codeine Methadone

Oxycodone Other opioidsOther analgesics

Source: Alcohol and Other Drug Treatment Services NMDS 2015-16

Policy responses

Restricting access to codeine medicines to prescription only from 1 February 2018• This includes analgesic preparations combined with other

pain relief medicines such as aspirin, paracetamol and ibuprofen

Real time prescription monitoring• Implementation of a national real-time monitoring

system of prescription drugs. • The system will provide an instant alert to pharmacists

and doctors if patients are receiving multiple supplies of prescription only medicines (also referred to as ‘doctor or pharmacy shopping’).

Breaking down the data silos

• AIHW continues to work withstakeholders to collect, analyse and report data on non-medical use of opioids

• Recent report released on 19 December 2017

International collaboration• AIHW and Canadian Institute

for Health Information (CIHI)• Analysis of comparable data between countries• Initial findings show similar trends between countries,

report due for release September 2018

The impacts of a tamper-resistant oxycodone formulation on opioid use and harms in Australia

27 - 28 March 2018, QT Hotel Canberra

Dr BRIONY LARANCENDARC, UNSW

The National Opioid Medications Abuse Deterrence (NOMAD) studyBriony Larance, Louisa Degenhardt, Nicholas Lintzeris, Raimondo Bruno, Amy Peacock, Michael Farrell

The Difference is ResearchThe Difference is Research

3

Disclosures

The NOMAD study was funded via an investigator-driven, untied educational grant from MundipharmaAustralia. The funder has no role in the design, conduct, analysis, interpretation or decision of what/where to publish.

I have also received untied educational grants from Reckitt Benckiser/Indivior and Seqirus for work unrelated to this presentation.

4

OxyContin®/ Reformulated OxyContin®

• OxyContin®= controlled release oxycodone (CRO)

• Reformulated OxyContin® = tamper-resistant formulation of CRO (TRF-CRO)

• One of the most widely prescribed opioids in Australia - concerns re: injection and harms; replaced with a tamper-resistant formulation

• 1st April 2014: PBS listing of Reformulated OxyContin®

The Difference is Research

National Opioid Medication Abuse Deterrence (NOMAD) study:

Degenhardt et al (2015). Evaluating the potential impact of a reformulated version of oxycodone upon tampering, non-adherence and diversion of opioids: The National Opioid Medications Abuse Deterrence (NOMAD) study protocol. Addiction, 110, 226-237

Following the introduction of Reformulated OxyContin®…

1. Population-level utilisation of oxycodone and other opioids?2. Extra-medical use of OxyContin®?3. Extra-medical use of other forms of oxycodone or other pharmaceutical

opioids?4. Injection of other illicit drugs?5. Attractiveness for tampering?6. Methods of tampering with Reformulated OxyContin® evolve/become

widespread?7. Unintended consequences?

Data source/custodianQ1

Population use of opioids

Q2OxyContin®

use

Q3Other pharm

opioid use

Q4Illicit drug injection

Q5Attractive-

ness

Q6Tampering

Q7Unintended

conseq’s

Population-based indicators of opioid utilisation

1. IMS Health opioid sales data •Use, extra-medical use and tampering of oxycodone, other pharmaceutical opioids and of other drugs2. NOMAD study prospective cohort • • • • • •3. Illicit Drug Reporting System (PWID) • • • •4. Sydney MSIC data • •5. Kirketon Road Centre NSP data • •6. Queensland NSP data (QMDS-NSP) • •Opioid-related morbidity7. New South Wales (NSW) Ambulance •8. Ambulance Tasmania •9. Hospital separations NSW •10. Hospital separations TAS •11. Emergency department data NSW •12. Emergency department data TAS •13. Royal Adelaide Hospital ED data •Opioid treatment and help-seeking14. PHDAS NSW •15. DASSA OST treatment episodes SA •16. ADIS NSW •17. ADIS TAS •

7

Data source/custodianQ1

Population use of opioids

Q2OxyContin®

use

Q3Other pharm

opioid use

Q4Illicit drug injection

Q5Attractive-

ness

Q6Tampering

Q7Unintended

conseq’s

Population-based indicators of opioid utilisation

1. IMS Health opioid sales data •Use, extra-medical use and tampering of oxycodone, other pharmaceutical opioids and of other drugs2. NOMAD study prospective cohort • • • • • •3. Illicit Drug Reporting System (PWID) • • • •4. Sydney MSIC data • •5. Kirketon Road Centre NSP data • •6. Queensland NSP data (QMDS-NSP) • •Opioid-related morbidity7. New South Wales (NSW) Ambulance •8. Ambulance Tasmania •9. Hospital separations NSW •10. Hospital separations TAS •11. Emergency department data NSW •12. Emergency department data TAS •13. Royal Adelaide Hospital ED data •Opioid treatment and help-seeking14. PHDAS NSW •15. DASSA OST treatment episodes SA •16. ADIS NSW •17. ADIS TAS •

Main components of the NOMAD study:

1. A prospective cohort of 606 people who misuse or tamper with pharmaceutical opioids

2. Illicit Drug Reporting System (IDRS) data, including additional module in 2014 and 2015

3. Routinely-collected indicator data (~240 individual series):• Opioid sales• Drugs used by clients at needle and syringe programs (NSP)• Opioid overdose/poisoning• Help-seeking and treatment• Mortality (not currently available)

8

• Interrupted time series (ITS*) analyses of opioid sales data and multiple routinely-collected health datasets.

* ITS can be used to examine impacts of interventions or “shocks” (i.e. introduction of Reformulated OxyContin®) while controlling for serial dependence within a given time series.

• Meta-analyses (weighted z-tests) were conducted to synthesise across data sources providing evidence for a given indicator.

Analytic approach

9

Q1: Was there a change in the population-level utilisation of oxycodone?

11

Q1: Population-level opioid utilisation

Key study outcome Nature of population

included

Summary of impact

Data sources informing

pooled estimates

Overall pharmaceutical opioid utilisation (OME mgs)

Total population No change Opioid sales data

Oxycodone utilisation Total population No change Opioid sales dataCR oxycodone 40mg Total population ↓ Opioid sales data

CR oxycodone 80 mg Total population ↓ Opioid sales dataCR oxycodone 10/15/20/30mg Total population No change Opioid sales data

Other oxycodone Total population ↑ Opioid sales dataOther prescribed pharmaceutical opioids Total population No change Opioid sales data

↓= significant decrease↑ = significant increase

12



included

Summary of impact


pooled estimates







13



included

Summary of impact


pooled estimates







14

Q2 and 3: Were there changes in the injection of OxyContin® or other

pharmaceutical opioids?

Q2 and 3: Extra-medical use of pharmaceutical opioids


included

Summary of impact

Data sources informing pooled estimates

Any pharmaceutical opioid injection

Sentinel (PWID) ↓ NOMAD cohort

Sentinel (PWID) ↓ NSP data*

Oxycodone injection


Sentinel (PWID) ↓ MSIC data

CR oxycodone 80mg injection Sentinel (PWID) ↓ NOMAD cohort

Other pharmaceutical opioid injection (excl. oxycodone)


Sentinel (PWID) No change MSIC data

* NSP data includes pooled z-scores across KRC/Clinic 180 ‘last drug injected’ data, MSIC ‘drug to be injected’ data and QNSP-MDS ‘drug intending to inject’ data.

19

Q4: Were there changes in the injection of illicit drugs?

20

Q4: Injection of illicit drugs

* NSP data includes: pooled z-scores across KRC/Clinic 180 ‘last drug injected’ data, MSIC ‘drug to be injected’ data and QNSP-MDS ‘drug intending to inject’ data.


included

Summary of impact

Data sources informing pooled estimates

Heroin Sentinel population

No change NSP data*

Amphetamine Sentinel population

No change NSP data*

21

Q5: How attractive was Reformulated OxyContin® for extra-medical use?


Q5: Attractiveness


included

Summary of impact


pooled estimatesMedian street price per 80mg tablet(CRO vs. TRF-CRO tablet)

Sentinel population

↓ NOMAD cohort

Strongly agreed difficult to inject (CRO vs. TRF-CRO)

Sentinel population

↑ NOMAD cohort

Intentions to tamper (CRO vs. TRF-CRO)

Sentinel population

↓ NOMAD cohort

25

Q6: Did methods of tampering evolve or become widespread?


Q5: Evolution and spread of tampering


included

Summary of impact


pooled estimatesSuccessfully tampered with TRF-CRO (ever) (Wave 2 vs. Wave 3)

Sentinel population

↑ NOMAD cohort

Past month tampering with TRF-CRO(Wave 2 vs. Wave 3)

Sentinel population

No change NOMAD cohort

28

Q7: Were there any unintended consequences (help-seeking, overdose)?

Q5: Unintended consequencesKey study outcome Nature of

population included

Summary of impact


pooled estimates

Drug overdose (all drugs) Total pop No change Available health data

Opioid overdose/poisoning Total pop No change NSW health service data

Other drug overdose/poisoning Total pop No change NSW health service data

Help-seeking for drugs (all helpline calls) Total pop No change Available ADIS data

Help-seeking for opioids Total pop No change NSW ADIS only

Help-seeking for other drugs Total pop No change NSW ADIS only

Opioid substitution therapy (total) Total pop No change Available OST data

Total new treatment entrants Total pop No change NSW PHDAS only

Treatment entry – oxycodone Total pop ↓ NSW PHDAS only

•‘Available health data’: pooled z-scores across drug overdose/poisonings data from Tasmania EDDC, Tasmania hospital, NSW EDDC, NSW APDC and Royal Adelaide Hospital emergency department data.•‘NSW health service data’ includes: pooled z-scores on opioid overdose from NSW ambulance data, NSW EDDC and NSW APDC.•‘NSW health service data’ includes: pooled z-scores on other (non-opioid) drug overdose from NSW ambulance data, NSW EDDC and NSW APDC.•‘Available ADIS data’ includes: pooled z-scores across NSW and Tasmanian ADIS data.•‘Available OST data’ includes: pooled z-scores across total number of OST patients in NSW (PHDAS) and South Australia (DASSA).

Q5: Unintended consequencesKey study outcome Nature of

population included

Summary of impact


pooled estimates

Drug overdose (all drugs) Total pop No change Available health data

Opioid overdose/poisoning Total pop No change NSW health service data

Other drug overdose/poisoning Total pop No change NSW health service data

Help-seeking for drugs (all helpline calls) Total pop No change Available ADIS data

Help-seeking for opioids Total pop No change NSW ADIS only

Help-seeking for other drugs Total pop No change NSW ADIS only

Opioid treatment program (total) Total pop No change Available OST data

Total new treatment entrants Total pop No change NSW PHDAS only

Treatment entry – oxycodone Total pop ↓ NSW PHDAS only

•‘Available health data’: pooled z-scores across drug overdose/poisonings data from Tasmania EDDC, Tasmania hospital, NSW EDDC, NSW APDC and Royal Adelaide Hospital emergency department data.•‘NSW health service data’ includes: pooled z-scores on opioid overdose from NSW ambulance data, NSW EDDC and NSW APDC.•‘NSW health service data’ includes: pooled z-scores on other (non-opioid) drug overdose from NSW ambulance data, NSW EDDC and NSW APDC.•‘Available ADIS data’ includes: pooled z-scores across NSW and Tasmanian ADIS data.•‘Available OST data’ includes: pooled z-scores across total number of OST patients in NSW (PHDAS) and South Australia (DASSA).

31

Key findings

• Qu 1: Decline in OxyContin® use (increase in Targin®) • Qu 2 and 3: Declines in OxyContin® and total oxycodone injection• Qu 4: No switching to other opioids or heroin (some differences in

MSIC data – a special case?) • Qu 5: Reduced attractiveness for tampering • Qu 6: Tampering increased, but among a small proportion and

infrequent use • Qu 7: To date, no evidence of other unintended consequences

Larance et al (2018) Impacts of a potentially tamper-resistant oxycodone formulation on opioid use and harms in Australia: Main findings from the National Opioids Abuse Deterrence (NOMAD) study. Lancet Psychiatry

32

Conclusions

• Clear impacts among PWID, with reductions in injection of OxyContin®/Reformulated OxyContin®, no switch to other oxycodone, and no clear evidence of a shift to other opioids or drugs.

• Did not appear to impact at population-level upon opioid use or harms.

• ADFs may make tampering more difficult, but limited impact addressing issues related to overprescribing, overuse and harms of opioids when taken via the intended route.

Larance et al (2018) Impacts of a potentially tamper-resistant oxycodone formulation on opioid use and harms in Australia: Main findings from the National Opioids Abuse Deterrence (NOMAD) study. Lancet Psychiatry

33

Acknowledgements• Many thanks to the NOMAD study participants, who generously shared their experiences.• NOMAD Investigators: Louisa Degenhardt, Briony Larance, Michael Farrell, Nicholas Lintzeris, Raimondo Bruno, Amy Peacock,

Robert Ali, Nancy White, Timothy Dobbins • Associate Investigators and NOMAD Advisory Committee members: Suzanne Nielsen, Gabrielle Campbell, Lesley Brydon,

Malcolm Dobbin, Adrian Dunlop, Angella Duvnjak, Mary Ellen Harrod, Paul Haber, Marianne Jauncey, Robert Kemp, Nghi Phung, Ann Roche and Hester Wilson.

• Other NOMAD study team members: Ivana Kihas, Toni Hordern, Elena Cama, Dominic Oen, Oluwadamisola Sotade and our team of interviewers in NSW, SA and TAS

• Special Acknowledgements: Billy Henderson (Mundipharma, NSW, Australia; IMS Health data); Jenny Stafford and Lucy Burns (National Drug and Alcohol Research Centre, NSW, Australia; Illicit Drug Reporting System data); Amanda Roxburgh (National Drug and Alcohol Research Centre, NSW Australia; National Illicit Drugs Indicator Project data); Marianne Jauncey and Allison Salmon (Uniting Medically Supervised Injecting Centre, NSW, Australia; medically supervised injecting centre client visit data); Ingrid van Beek and Karen Chronister (Kirketon Road Centre and Clinic 180, NSW, Australia; last drug injected data for two inner-Sydney needle and syringe programmes); Robert Kemp and Abhilash Dev (Queensland Health, Queensland Government, Australia; Queensland Minimum Data Set for the Needle-Syringe Programs); Peter Mansfield (Department of Health and Human Services, Tasmania Government; Tasmanian Emergency Department Data Collection data/Admitted Patient Data Collection data); Orson Rapose (Turning Point, VIC, Australia; Alcohol and Drug Information Service data for Victoria, Australia); Ambulance Australia, Tasmania Department of Health and Human Services, Tasmania Government (Tasmanian Ambulance data); Ian Richards (Community Based Treatment Division, Drug and Alcohol Services South Australia, SA Health, South Australia, Australia; Alcohol and Drug Information Service data for South Australia, and opioid substitution therapy data from Drug and Alcohol Services South Australia); Pia Salmelainen (New South Wales Ministry of Health; Pharmaceutical and Drugs of Addiction System data); David Lester (St Vincents Hospital, New South Wales; New South Wales Alcohol and Drug Information Service data); Francine Smith (Tasmanian Department of Health and Human Services, TAS, Australia); and the National Clinical Terminology Service from the Australian Digital Health Agency for assistance with SNOMED mapping and codes. Thanks also to the Centre for Epidemiology and Evidence, New South Wales Ministry of Health for preparation and provision of data from (a) the Emergency Department Records for Epidemiology and (b) Combined Admitted Patient Epidemiology Data held by the New South Wales Ministry of Health Secure Analytics for Population Health Research and Intelligence.

• NHMRC fellowships: Briony Larance, Louisa Degenhardt, Amy Peacock• Mundipharma: Untied educational grant

34

Thank you!

Briony LaranceSenior Research Fellow (NHMRC ECF)NDARC, UNSW Australia: (02) 9385 0241 : [email protected]

SafeScriptVictoria’s Real-Time Prescription Monitoring system

Australian and New Zealand School of Government

Breaking the Data Silos Conference

27 March 2018

Harms from high-risk prescription medicines

Deaths in Victoria 2011 2012 2013 2014 2015 2016

Prescription medicines 275 306 313 316 358 372Illicit drugs 153 133 166 164 227 257Road toll 287 282 243 248 257 291

• 34 coronial findings since 2012 where Coroners have called for a monitoring system in Victoria

• All key health and consumer organisations strongly advocate a monitoring system

SafeScript: sharing data between clinicians

If dispensed, record

captured in the system

Doctor(or other

prescriber)

PharmacistsPharmacist

decides whether to

dispense or not

Pharmacist checks system

Patient presents

prescription at pharmacy

If safe, doctor writes a

prescription

Doctor checks the

system

Patient visits doctor

Doctor decides whether to

prescribe or not

DHHS has access to SafeScript to oversee compliance and the

appropriate supply of medicines

Supporting activity

Support for Clinicians and Consumers• Training for prescribers and pharmacists

• Public Awareness Campaign

• “GP Champions” Initiative

• Minor enhancements to the Alcohol and Other Drugs (AOD) treatment sector

This is in addition to broader activity being implemented through Victorian DHHS• Significant new investment in AOD treatment sector

• AOD Workforce Strategy and development projects

Implementation Details

Scope of medicines to be monitored through SafeScript• All Schedule 8 Medicines

• Some Schedule 4 medicines including all benzodiazepines

Mandatory use by prescribers and pharmacists• After transitional period of 18 months

Implementation Approach• Implementation in a study area will commence in late 2018

• Review of deployment activities before further roll-out

Stakeholders influence

• An Expert Advisory Group provides advice about key policy and implementation aspects of SafeScript that affect patients and health professionals.

• Early feedback from the EAG and other key stakeholders indicated a need for a system with:

• minimal interruption to clinical workflow

• integration with existing prescribing and dispensing software

• minimal or no additional data entry required by clinicians

• This led to a reconsideration of the available technology

• Move to seek more contemporary data and technology solutions

Being smarter about data and technology

Victorian RTPMSourcing Data SafeScript architecture provides a more efficient approach to sourcing data by

leveraging existing digital health assets to integrate with ePrescription Exchange Services (PES)

Technology-Scalability andPerformance

SafeScript architecture leverages more contemporary technology on a cloud-based platform which can scale indefinitely to support any future needs including growth in prescription volumes and number of users without requiring any significant system redevelopment.

Integration into health professionals workflow

Capability to reticulate notifications to health professionals to ensure integration into health professionals workflow

Additionally, the solution will provide an application programming interface (API) which will allow for seamless integration with prescriber and pharmacy software.

Patient identification and matching

The Victorian approach provides a real-time data enrichment function that will enable retrieving the patient IHI through calls to the HI services. Therefore, the patient identification processes for will be more reliable.

National integration As other jurisdictions develop monitoring systems, coordination with their data will provide information about cross-border supply of high risk medicines. Meanwhile, our legislative framework enables us to capture data about all prescribing and dispensing to Victorian patients.

SafeScript data

• Patient name • Patient address• Demographics • Prescriber name and address, specialty • Number of prescribers • Pharmacy name and address• Number of pharmacies• Monitored drug(s) • Drug dose• Drug combinations• Number of prescriptions per patient

Current Progress and Activity

• The Bill to establish the legislative framework for the system recently passed through Victorian Parliament

• Draft regulations and Regulatory Impact Statement (RIS) was released for consultation

• Fred IT Group has been appointed to build the system

• Working with a consortium, comprising all Victorian Primary Health Networks and NPS MedicineWise, to develop training for prescribers and pharmacists

• Market research for concepts for the Public Awareness Campaign

• Planning for implementation including communication and stakeholder engagement

For more information

https://www2.health.vic.gov.au/public-health/drugs-and-poisons/safescript

Email: [email protected]

STAY ON THE SAFE SIDE

https://www2.health.vic.gov.au/public-health/drugs-and-poisons/safescript

overview of non- medical use of pharmaceutical opioids in

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