Australian Capital Territory

In the Australian Capital Territory (ACT), the Medicines, Poisons and Therapeutic Goods Act 2008 and the Medicines, Poisons and Therapeutic Goods Regulation 2008 Schedule 1, Part 1.9 (Pharmacists and employees) authorises pharmacists to administer medicines, including medicines for injection. This includes all medicines for injection in:

• schedule 2 and schedule 3 of the Poisons Standard without prescription; and
• schedule 4 and schedule 8 in accordance with the prescription issued by an authorised prescriber to the patient.

Buprenorphine is classified as a schedule 8 Controlled Drug. Pharmacists undertaking the administration of long-acting injectable buprenorphine (LAIB) must only administer in accordance with a prescription.

Community pharmacies in the Australian Capital Territory must be licensed to dispense methadone, buprenorphine or buprenorphine/naloxone for treatment of drug dependency. Pharmacists can apply to HPS to obtain an Opioid Dependency Treatment Centre Licence by submitting an Application for Opioid Dependency Treatment Centre Licence (Pharmacist).

All pharmacists dispensing treatment must successfully complete training for the safe administration and dispensing of opioid maintenance treatment. These requirements are outlined in the Medicines, Poisons and Therapeutic Goods (Guidelines for treatment of opioid dependency) Approval 2018.

For information on course availability, please contact Canberra Health Services Alcohol and Drug Services.

Pharmacists in the ACT must also dispense methadone, buprenorphine or buprenorphine/naloxone in line with the National Guidelines for Medication Assisted Treatment of Opioid Dependence. Pharmacists should also comply with the Opioid Maintenance Treatment in the ACT: Local Policies and Procedures wherever possible.

For further information, please visit Opioid Maintenance Treatment I ACT (health.act.gov.au).

Prior to the administration of LAIB, pharmacists in the Australian Capital Territory must ensure they: 

• complete an accredited pharmacist administering medicines by injection course;
• complete Opioid Maintenance Treatment in the ACT - Pharmacist Training Program provided by Canberra Health Services; 
• complete this accredited clinical training course which covers:
  • pharmacology and pharmacokinetics of buprenorphine
  • compares available formulations, including dose titration
  • correct administration techniques
  • practical considerations for providing a LAIB service
  • recognition and management of side effects
  • documenting the service 
• undergo supervised practical injection training for administration of LAIB
  • this may be facilitated using a blended model including attending and observing a public clinic (Canberra Health Service, Alcohol and Drug Service at Building 7 at The Canberra Hospital can facilitate this via appointment only) or observing a private prescriber/nurse currently providing this service.

Pharmacists administering LAIB should electronically document the administration of the medicine and provide documentation to the patient’s LAIB prescriber.

Queensland

Buprenorphine is classified as a Schedule 8 – Controlled Drug under the Therapeutic Goods (Poisons Standard – February 2023) Instrument 2023.  

Long-acting injectable buprenorphine is currently the recommended treatment for opioid dependency due to its improved safety profile, regime simplicity and greater convenience for patients compared to alternative treatments.

In Queensland, pharmacists are authorised under the Medicines and Poisons (Medicines) Regulation 2021 to administer approved opioids, including long-acting injectable buprenorphine, for a patient with a prescription from an authorised prescriber. 

Pharmacists do not require approval from Queensland Health to dispense or administer long-acting injectable buprenorphine. 

Pharmacists administering long-acting injectable buprenorphine should be familiar with formulation specific information and must be an appropriately-trained pharmacist immuniser. 

Pharmacists are required to check QScript prior to the dispensing and administration of long-acting injectable buprenorphine in accordance with the Queensland Health Monitored Medicines Standard. Importantly, long-acting injectable buprenorphine prescriptions must be dispensed before being administered to the patient. 

Pharmacists should ensure that appropriate clinical records are kept in relation to the administration of the long-acting injectable buprenorphine, including details of the administration site.

For more information, please visit the Queensland Opioid Treatment Program I Queensland Health.

Tasmania

Buprenorphine is classified as a Schedule 8 – Controlled Drug under the Therapeutic Goods (Poisons Standard – February 2023) Instrument 2023.  In Tasmania pharmacists who are accredited to dose under the Tasmanian Opioid Pharmacotherapy Program (TOPP) currently administer Schedule 8 drugs in other formulations (oral liquid, sublingual tablet and film) in the treatment of opioid dependence.  

The legislative framework in Tasmania supports pharmacists to administer depot buprenorphine.  The Poisons Act 1971 allows a pharmacist to supply (which includes administration) narcotic (Schedule 8) substances to a person in accordance with a valid prescription, and the interpretation of the term ‘supply’ in the Poisons Act 1971 includes administration. 

Pharmacists who are authorised pharmacist immunisers with the Tasmanian Department of Health and accredited to dose under the Tasmanian Opioid Pharmacotherapy Program (TOPP) in an approved pharmacy can now gain an additional accreditation to administer depot buprenorphine for the treatment of opioid dependence to clients in community pharmacy. Pharmacy practice settings must meet the required standard for conducting vaccinations in Tasmania.

This training will form part of pre-requisite training required for pharmacists to administer depot buprenorphine to both support increased awareness of depot buprenorphine and facilitate pharmacist injection of depot buprenorphine in Tasmania. This training can be conducted by any Tasmanian pharmacist and there are no pre-requisites to sitting this training.

The Australasian College of Pharmacy, and their partner Guild Learning and Development, would like to thank the Tasmanian Government for their financial and subject matter assistance in developing this course.