6.8.1 HistoryThe first formal methadone program in the ACT commenced in 1979 at the Woden Valley Hospital. Prior to this a number of private practitioners were involved in methadone treatment of private clients, but not in a regulated or co-ordinated program.
The existing ACT public methadone treatment program has undergone rapid change and expansion in recent years. Many of these changes were precipitated by:
- the 1992 ACT Legislative Assembly Select Committee on Drugs report "Methadone Treatment Services in the ACT" which recommended a number of changes to the existing methadone program; and
- the strong methadone consumer lobby groups which exist in the ACT. Approximately every 4-6 weeks a Methadone Program Development Advisory Meeting (MPDAM) is held to discuss problems, changes to the program etc. Three consumer lobby groups are represented at this meeting.
6.8.2 Current situationA range of services are provided through the public program, including assessment, information and referral; methadone prescribing and methadone dispensing.
The Alcohol and Drug Service, ACT Department of Health employs 2 career medical officers, both of whom prescribe methadone. There are no private methadone prescribers in the ACT at the present time although this option is being explored and a pilot program may be introduced in 1995.
Approximately 90% of clients are treated at purpose built clinics at Woden and Civic. Dispensing is also provided at community pharmacies. There are five pharmacies in the ACT who are approved to dispense methadone to opioid dependent persons, 3 of which have clients at the present time. There is also one pharmacy in Queanbeyan, NSW, which dispenses to approximately 20 clients who are prescribed for in the ACT.
Counselling is provided on a voluntary basis through Alcohol and Drug Service counsellors or counsellors from non-government agencies such as ADD Inc.
Clients who receive take-away methadone doses are required to pay $20.00 per week if employed, or $10.00 per week if they hold a concession card. Community pharmacies are not permitted to charge methadone clients more than $30.00 per week.
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6.8.3 StatisticsThe number of clients in the public sector in the ACT since 1986 are contained in Table 11.
Expressing these levels of participation as rates per thousand of population aged between 15 and 44 years (the primary age group of opioid dependent persons) results in the following statistics:
The participation rate in the ACT was relatively stable from 1986 to 1991, having increased from 0.46 to 0.56 persons per thousand over this period, followed by a significant increase to 2.06 persons per thousand in 1994. This reflects the timing of changes to the legislative and administrative environment of the program.
Table 11: Numbers of clients in ACT, 1986 to 1994