Methadone

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The Alcohol & Drug Information Service (ADIS) is a free and confidential counselling helpline for NSW residents with concerns around alcohol and/or drug misuse and is available 24 hours a day, 7 days a week. ADIS is staffed by professional counsellors who provide education, information, counselling, support and referrals to other appropriate services in NSW.

Are you worried you could be drinking too much or consuming drugs in a way that has become a problem? Are you worried about your friends or family finding out and want to get help quickly and quietly? Are you worried about the drug use of someone close to you – maybe a family member or friend? Maybe you just want to know where someone can get help? 

ADIS clinicians understand the difficulties of speaking out, seeking help and finding appropriate drug and alcohol treatment, and use their knowledge and experience to assist you and answer questions, such as:

• How can I cut-down or stop my alcohol or drug use?
• What help can I get?
• Do I have to wait long to get help?
• Can anyone ring ADIS?
• Who do I talk to when I ring ADIS?
• Will drug and alcohol treatments be difficult?
• What is this drug doing to me?
• What are the short and long term problems that could develop if I continue using?
• Will ADIS tell anyone that I rang?
• What can I expect when I ring?
• Does ADIS record calls?

You can call ADIS 24 hours a day, 7 days a week on 1800 250 015 or for Sydney Metropolitan 02 8382 1000 or alternatively you can start a Web Chat.

ADIS Web Chat is available from Monday to Friday 8.30am – 5pm (including public holidays).

ADIS also has a range of telephone lines offering specialised drug and alcohol information and support to particular groups.

​​The Alcohol & Drug Information Service (ADIS) Web Chat is a live online conversation with a professional counsellor. The service is free, confidential and open to anyone affected by alcohol and other drugs, including people concerned about their own use, or about a family member or friend. Web chat is only available for people living in NSW.

The service is provided by ADIS at St Vincent's Hospital, in partnership with the NSW Ministry of Health.

What to expect

• A counsellor will chat with you about your alcohol or other drug concerns
• A counsellor can provide a referral or contact information for relevant alcohol and drug services in NSW
  
• Our chat is confidential unless you disclose any intention to harm yourself or others.
• WebChat is provided in English however if you prefer to speak in a language other than English we would be happy to arrange a telephone call with you through the Translating and Interpreting Service (TIS National). Please call the Alcohol and Drug Information Service on 1800 250 015 to arrange this.

Emergency Assistance

Call Emergency Services on 000 if you:

• require urgent medical attention or
• are in immediate danger or
• are at risk of harming yourself or someone else.
  

Your Service Hub is an online directory of alcohol and other drugs support, health and welfare services. If you need support for your own or someone else's substance use, you should use terms in Find Services like:

• drug and alcohol family support
  

• drug and alcohol Aboriginal services 
  

• drug counselling
  

• drug and alcohol rehabilitation
  

• drug and alcohol residential treatment
  

Use your suburb name to narrow the search to services near you.

Not sure what service you need? Call the Alcohol and Drug Information Service on 1800 250 015.

Naloxone provides a significant opportunity to save lives because opioid overdoses tend to happen gradually, rather than suddenly. Opioids include pain-relieving drugs legally prescribed by a medical professional such as oxycodone, morphine, codeine and fentanyl, as well as illegal drugs such as heroin. During an overdose, opioids slow down or stop a person’s breathing, which may eventually result in death (see ‘Signs of opioid overdose’ below). However, it is possible to prevent death by administering naloxone to reverse the effects of the overdose. For this reason it is best to avoid using opioids alone, as naloxone can only help if someone can administer it quickly. 

Please note:The take home naloxone program includes instructions for performing rescue breathing and chest compressions. Before doing so, refer to the National COVID-19 Clinical Evidence Taskforce guidance on basic life support for adults in the community during the COVID-19 pandemic (PDF).

Opioids are responsible for over three deaths in Australia per day (Australian Bureau of Statistics). Prescribed opioids account for 70 per cent of opioid-induced deaths either by accident or through misuse. In 2018 the highest number of heroin-induced deaths was seen since 2000.

1. What is naloxone?
   
2. Who is naloxone for?
3. Take home naloxone in NSW
4. Where can I get naloxone?
   
5. Signs of opioid overdose
6. Pharmaceutical opioid use
   
7. More information

What is naloxone?

Naloxone is a drug that reverses the effects of an opioid overdose. In technical terms naloxone is a short-acting opioid antagonist that stops the central nervous system slowing down, giving a person experiencing an overdose the ability to breathe normally again. Naloxone only works if a person has opioids in their system.

Naloxone is available in a very easy to use nasal spray, and as a pre-filled injection. Until recently, naloxone has only been administered by medical staff or emergency service officers. Now, with basic training it can be administered by anyone.

Who is naloxone for?

Naloxone is for anyone at risk of overdosing on opioid drugs or anyone who may witness an opioid overdose.

People in the following circumstances should consider keeping a supply of naloxone close by: 

• People on high doses of opioid pain medicines 
• People who use opioid drugs 
• People returning to opioid use after a period of stopping or quitting 
• People who use opioids in combination with other drugs or medicines
• People who use illicit drugs, including cocaine or other stimulants (illicit drugs may contain unexpected substances, including opioids)

Family, friends or loved ones of people who use opioid drugs.

Take home naloxone in NSW

Take home naloxone programs, for people at risk of witnessing or experiencing an opioid overdose, have been established in Australia and internationally to increase awareness of naloxone, and reduce harm and death from overdose. Having naloxone at home enables community members to access the medicine quickly when and where they need it to treat an opioid overdose. 

Take Home Naloxone is now available from an increasing number of community pharmacies, public alcohol and other drugs services and some non-government health and welfare services across NSW. 

Naloxone is also available on prescription by a doctor or over the counter from a community pharmacy.

Where can I get naloxone?

Naloxone in the form of the Nyxoid® nasal spray and Prenoxad® pre-filled syringe are available for free without a prescription from registered community pharmacies, Needle and Syringe Programs (NSP) and participating non-government organisations (NGOs) and private services in NSW.

Pharmacies

Find your local participating pharmacy.
Tip: With the list open  use the search function (Ctrl and F keys) to find your postcode or suburb.

Pharmacies list (PDF)

NSW Needle and Syringe Programs

Naloxone is also available from some Needle and Syringe Program (NSP) sites across NSW. Please contact your local NSP service to confirm naloxone availability.

Needle and Syringe Program sites

NGOs and private services

Find your local participating non-government organisations (NGOs) and private service.

NGOs & private services list (PDF)

Information about overdose

Pharmaceutical opioid use

There is a high risk of accidental overdose from pharmaceutical opioids such as fentanyl when used other than by your doctor's instructions, due to its potency and very fast action once inside the body. For example, fentanyl patches that attach to the skin can cause fatal overdose when heat is applied over the top, or if someone does not keep track of how much and how often it is being taken.

If you are prescribed a pharmaceutical opioid only use it as prescribed by your doctor and pay attention to any warning or caution advice.

More information

Check out the A-Z of Drugs listing and Support Services pages, including the NSW Opioid Treatment Program page for further information.

For further enquiries on the take home naloxone Intervention in NSW email MOH-naloxone@health.nsw.gov.au.

Information for NSW public health services, Medically Supervised Injecting Centres (MSIC) and non-government and private service providers can be found at health.nsw.gov.au/aod/programs/Pages/naloxone. For information on the Commonwealth Government Take home naloxone pilot visit health.gov.au/initiatives-and-programs/take-home-naloxone-pilot.

For free and confidential advice give an Alcohol and Drug Information Service (ADIS) counsellor a call on 1800 250 015, they are available 24 hours, 7 days a week to provide confidential support and advice.

The NSW Opioid Treatment Program (OTP), also known as opioid agonist treatment or opioid substitution treatment, provides pharmacotherapy and support services to people with an opioid dependence. Treatment may be provided as a short term measure to assist people to stop using other opioids, or for long term maintenance.

The OTP is provided through public clinics, private clinics, general practitioners (GPs) and community pharmacies (find a pharmacy near you), and correctional facilities, and may be provided alongside other treatments such as counselling or residential rehabilitation. The pharmacotherapy medicines used in the NSW OTP are methadone, buprenorphine – inc​luding depot buprenorphine, given in an injection under the skin weekly or monthly – and buprenorphine-naloxone.

1. What is opioid dependence?
2. What are pharmacotherapy medicines?
3. NSW Opioid Treatment Program
4. Mixing OTP medicines with other drugs
5. Driving Safety
6. Talk to someone about OTP
7. FAQs for OTP patients during COVID-19 (PDF)

What is opioid dependence?

When some people experience pain, both physical and or psychological, they may rely on opioids to make their body and mind feel better. People who are dependent on opioids find it very hard to stop using or cut down because of withdrawal symptoms. Stopping opioid use abruptly can lead to withdrawal symptoms, these can begin to occur within only a few hours after last use.

Symptoms can include:

• Sweats and chills
• Sleeplessness and broken sleep
• Uneasiness/anxiety
• Feeling restless
• Diarrhoea
• Restless legs
• Stomach and leg cramps
• Nausea
• Runny nose and eyes
• Joint pain
• Cravings (wanting opioids very badly)

Some people may experience withdrawal after they have been on strong medicines prescribed by their doctor, such as oxycodone (Endone) or codeine. While others may experience it after using illicit drugs like heroin. Dependence is a medical condition, regardless of how people become dependent or what drug they use, everyone is entitled to treatment.

What are pharmacotherapy medicines?

Methadone, buprenorphine and buprenorphine-naloxone belong to a group of sedating and strong pain-killing drugs called opioids. Both methadone and buprenorphine are long-acting opioids, therefore only one dose per day is usually needed to prevent the uncomfortable symptoms of opioid withdrawal. Methadone and buprenorphine may also be prescribed by clinicians to patients to treat severe or chronic pain or in palliative care settings.

The effects of methadone and buprenorphine can include relief from pain and a feeling of wellbeing, but can also cause nausea, sleepiness and long term use can have effects on male reproductive health, libido and cause sweating and constipation.

Buprenorphine is effective at blocking the effect of other opioids, as it binds tightly to the opioid receptors in the brain. It comes in three different forms, a tablet (Subutex) or film (Suboxone) which are dissolved under the tongue, and a long acting injection (depot- Buvidal and Sublocade). For depot buprenorphine, injections last a week or a month.

Buprenorphine may also be mixed with naloxone (buprenorphine-naloxone) to discourage people injecting.

NSW Opioid Treatment Program

The purpose of the OTP is to provide patients with access to treatment for opioid dependency, with a focus on improving patients’ health, wellbeing and engagement with their families and community.

Patients can access treatment through public drug and alcohol services, private clinics, GPs and community pharmacies. The type of treatment they access will depend on the complexity of the care they need and their location.

Treatment through public clinics is free for patients with the most complex care needs or for those needing supervised dosing.

In many cases, patients can be treated in community settings such as private GP clinics with management of methadone or buprenorphine dispensed daily through community pharmacies.

Most patients are required to start the program with a nurse or a pharmacist watching them take the methadone or buprenorphine every day. After some time patients may be able to have some of the medication to take at home, but this is only after the patient and the doctor are comfortable with how the treatment is progressing, and it is safe to do so.

Long-acting depot buprenorphine does not require supervision because once the medication is injected it is slowly released over days or weeks, depending on the formulation.

Patients and doctors will decide together what treatment plan and medication is best. Some patients may want to take the medication for a short amount of time, other patients may feel they need the medications for longer, each patients’ needs are different.

Clinicians delivering the OTP are guided in practice by the NSW Clinical Guidelines: Treatment of Opioid Dependence.

Only patients with opioid dependence are suitable for the OTP program. Similar opioid treatment programs are available in all states and territories.

Mixing OTP medicines with other drugs

Methadone and buprenorphine alone are not risky to take but it is necessary to understand how they interact with other sedating substances – particularly benzodiazepines and alcohol. There is a risk of over-sedation when taking sedating medications or alcohol while being treated with methadone.

It is important that patients discuss with their clinicians (doctor, nurse or pharmacist) about all their prescriptions and their other substance use. Doctors can choose a different combination of prescription medication to reduce the risks.

Driving Safety

It is not risky to drive when on a stable dose of methadone or buprenorphine, as long as you are not taking other sedating substances or drugs at the same time.

In the first two weeks of buprenorphine and first four weeks of methadone treatment, and any time where the dose is changed by 5mg or more, you are strongly advised NOT to drive or operate heavy machinery.

For more information, visit drivingsafety.com.au 
or
Download the Driving Safety and Medicines Fact Sheet. 

Pregnancy and child safety

Babies and children can die from taking methadone or buprenorphine. It is important that any takeaway doses are stored in a locked cupboard or drawer, and to never take the medicines in front of children. Depot buprenorphine is a good alternative for parents, as there are no takeaway doses and therefore no chance of exposing children to the medicines.

Methadone and buprenorphine must never be given to babies or children, unless prescribed to them. If a child has taken it call 000 (triple zero) immediately.

If you are dependent on opioids and pregnant, or planning to become pregnant, it is important you consider getting treatment for opioid dependency. Substance Use in Pregnancy and Parenting Service (SUPPS) can coordinate treatment, call Alcohol and Drug Information Service (ADIS) on 1800 250 015, for counselling and referrals 24 hours a day, 7 days a week.

Talk to someone about OTP

The Opioid Treatment Line (OTL) is a phone based service that provides opioid pharmacotherapy information, referrals, advice and a forum for pharmacotherapy or treatment concerns. OTL assists people who want to know more about the system of opioid treatment in NSW, including how to get onto a program, and what they should expect from clinics and doctors providing the service.

For more information contact the Opioid Treatment Line (OTL) on 1800 642 428, Monday to Friday 9.30am to 5.00pm with temporarily extended service hours to include 9:30am - 2:00pm on weekends and public holidays to support Covid-19 related queries.​​

For information from a consumer led organisation, contact NSW Users and AIDS Association (NUAA).

NEW! Consumer guideline series is available online through NUAA.

For free and confidential advice call the Alcohol and Drug Information Service (ADIS) on 1800 250 015. Counsellors are available 24/7 to provide information, referrals, crisis counselling and support. Or start a Web Chat with an ADIS counsellor online Monday to Friday, 8.30am – 5pm.

Families, friends and loved ones can play a critical role in the recovery of people who experience alcohol and other drug problems, however they are often focused on the needs of others while they neglect their own their own health and wellbeing.

The Family and Friend Support Program (FFSP) is an online cognitive behavioural therapy program to support people who are caring for or supporting someone with alcohol and other drug use issues.

FFSP is based on a series of modules and includes information and activities on how families and friends can help their loved ones, with a specific emphasis on the person providing the support and their often unmet needs. The program is also suitable for health professionals.

For information on how to start a conversation with your loved one about their alcohol and or other drug use, tips on how to look after yourself and other resources visit our For Families mini-site.

Cost

The program is free and available 24 hours a day, 7 days a week. 

Please note that for Health Professionals there are costs involved in the 5-step training. Details about the training can be found on the Health Professionals portal in FFSP (under the icon 5-step).

The FFSP is supported by funding from the Australian Government Department of Health.

PeerLine is confidential service run by the NSW Users and AIDS Association (NUAA). NUAA works to improve the health, welfare and dignity of people who use drugs. 

PeerLine is a free, confidential peer supported telephone service for people who use drugs, who are on the Opioid Treatment Program or seeking treatment. Trained peers will help you with information, advice and advocacy

PeerLine is available from 9.00am to 5.00pm Monday to Friday (excluding public holidays).

Call for free on 1800 644 413 or email peerline@nuaa.org.au to connect.

The OTL (formerly MACS) provides information, referrals, support and a forum for pharmacotherapy concerns.

This is a helpline for people who:

• are opioid dependent and want to know more about what is available for them; or

• are currently on an opioid pharmacotherapy program (treatment using prescribed methadone or buprenorphine) or want to be on a program and have questions about treatment; or

• are having issues with their opioid pharmacotherapy treatment and need information or assistance; or

• want to know more about the system of opioid treatment in NSW; or

• are health professionals seeking information, advice and referral

OTL also maintains a central register of complaints and concerns about opioid treatment and providers and ensures NSW Health hears your issues to help improve opioid pharmacotherapy treatment in NSW.

OTL was established to assist and support opioid treatment in NSW. Listening to individual stories, answering questions, recording problems and treating clients and professionals with dignity and respect is the basis of OTL work.

OTL is a confidential, anonymous service giving voice to those who would like to raise their issues privately or officially. OTL works with both the patient and the treatment provider in order to help clarify and resolve problems, or can act as an intermediary, explaining the reasoning behind certain decisions and how they relate to the Opioid Treatment Guidelines.

OTL is often the first place opioid dependant people contact when trying to access treatment. OTL can provide the contact details of services that are available. The availability of OTL means individuals can be helped through the understanding of the various treatment options.

OTL also provides feedback to other organisations, involved with opioid pharmacotherapy treatment including NSW Health, Justice Health, the Health Care Complaints Commission (HCCC), NSW Pharmaceutical Regulatory Unit, NSW Users and AIDS Association (NUAA).

OTL can collect information from callers to assist in resolving issues in treatment or accessing treatment.

Frequent calls to OTL include questions around:

• Types of treatment available
• Where and how to access treatment
• NSW Guidelines around treatment and clients' and providers' rights and responsibilities
• Problems contacting or communicating with treatment providers
• Transferring between areas, states and countries
• Dissatisfaction with treatment

Whatever your question or concern, OTL will listen and help wherever possible.