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Federal government funding shake-up risks leaving thousands of Queensland, NSW opioid addicts with nowhere to go for treatment

Key points:

  • Commonwealth government reforms will make it cheaper for patients to buy “life-sustaining” medicines for opioid addiction
  • While the overarching aim has been applauded, some private facilities say it will force them to shut
  • They say closures could leave thousands of patients without care because public services are already overwhelmed

More than a dozen private opioid treatment services in Queensland and New South Wales are at risk of closure because of changes announced in last month’s federal budget, say clinic operators.

If the 17 facilities shut, they say it would displace more than 4,500 patients with opioid dependence, potentially plunging some into illicit drug use and crime to stave off withdrawal symptoms if they cannot get care elsewhere.

The potential crisis is a result of government changes to the Opioid Dependence Treatment Program (ODTP) that mean patients will be able to buy medicines – including methadone or buprenorphine – through the Pharmaceutical Benefits Scheme (PBS) at some community pharmacies.

Currently people requiring the medication attend state-run facilities, some GPs or private pharmacies and clinics.

A close-up of brown Aspen Methadone Syrup bottles
Many state-run drug treatment clinics are already at capacity.(ABC News: Mark Leonardi)

Federal Health Minister Mark Butler said “for too long” people seeking help for opioid dependence have been “treated as second-class citizens” and “locked out” of getting their medication affordably through the PBS.

“Once the change comes into effect, Australians seeking help for opioid dependency will be able to buy their treatments from pharmacies, paying a PBS co-payment instead of uncapped private prescription fees,” Mr Butler said.

Mark Butler wearing a suit and red tie stands in front of the australian and aborignal flags during press conference
Mark Butler says the change will make it cheaper for patients to access medication.(ABC News: Ian Cutmore)

However, private pharmacies and clinics in Queensland and New South Wales say their role in treating up to 10 percent of the nation’s ODTP patients has been overlooked and their revenue will be slashed when the changes come into place on July 1.

While efforts to make the medications cheaper have been universally applauded, there are not enough state clinics, GPs and pharmacies to take on thousands of extra patients.

Pharmacist Andrew Pfeffer owns a specialist drug treatment clinic at Logan, in south-east Queensland, which supports around 210 people living with opioid dependence.

He said about 60 per cent of the patients, including a top business executive recovering from surgery, became addicted to prescription opioid painkillers. Others use illicit drugs like heroin.

A close-up of pharmacist Andrew Pfeffer, wearing a button-up shirt
Pharmacist Andrew Pfeffer says he will have to close his Logan clinic on July 1 under new arrangements planned by the Commonwealth.(ABC News: Mark Leonardi)

They pay the clinic $42 a week for opioid substitution medications and unlimited bulk billed appointments with health care workers located on site.

“Under the new system a general patient would pay $30 a month for care. If you hold a concession card or health care card, you’d pay $6 or $7 a month,” Mr Pfeffer said.

“Which is a fantastic investment in care and a much-needed change to see equity brought to such a marginalised cohort.”

Brown bottles of Aspen Methadone Syrup lined up on a shelf
Experts say medications such as Methadone and Buprenorphine are vital in stabilising the lives of people living with opioid dependence.(ABC News: Mark Leonardi)

But he said it will destroy the income of private dispensaries and clinics – like his and about 16 others – filling gaps in care in New South Wales and south-east Queensland.

“1st of July we will be closed,” Mr Pfeffer said.

“Once we close the patients will be left to their own devices – there will be no treatment for them at this service.”

Sheets of medication stacked up
According to the Australian Institute of Health and Welfare, on a snapshot day in 2022 more than 55,000 Australians were receiving medication for opioid dependence.(ABC News: Mark Leonardi)

State-run drug treatment clinics and some accredited GPs also prescribe opioid replacement medications, but in most places the services are already full.

“There is nowhere else to go,” Mr Pfeffer said.

The pharmacist is warning of “imminent disaster” for the wider community and patients, many of whom have addiction issues stemming from trauma.

An empty waiting room with grey chairs
There’s fears private opioid treatment dispensaries will close as a result of the reform.(ABC News: Mark Leonardi)

“They’ll be forced, without an option, onto the illicit market which will result in an increase in crime, petty crime, and property theft, acute presentations to emergency departments, intoxication and a rise in viral infectious diseases,” Mr Pfeffer said.

He said closures would also remove a secure environment for about 40 GPs and nurse practitioners who specialise in the “tricky” field of prescribing replacement medications for illicit opioids.

Mr Pfeffer said the federal government failed to properly consult with the operators.

“The only option to avoid Armageddon is for the Commonwealth to delay the implementation and allow a proper consultation process to ensure that no patient is left behind and no community is upset,” Mr Pfeffer said.

‘People will die from it’

Sam is hidden by shadows
Sam fears the lives of addicts will be at risk if the private clinics shut down.(ABC News)

Sam* has spent much of his life in and out of jail with a chronic addiction to heroin and Oxycodone.

“I had a wild childhood, I was a street kid, in and out of boys’ homes, jail, just had a hard childhood. Turned to drugs, it went from there.”

Now aged in his 40s, he said starting daily methadone treatment through a non-PBS pharmacy about 10 years ago has saved his life and helped repair his relationships.

“I’ve been out of jail for a long time now, I’ve actually got myself together — I’ve got a house, I’m doing well,” Sam said.

The Newcastle resident said if clinics close “people will die from it”.

“If they do this, they’re going to have a big epidemic,” he said.

“Heroin addicts, or opiate addicts, you can’t go through a day without it, you will do anything to get it,.”

Kurt Strassmeir owns the Newcastle pharmacy that treats Sam and about 350 other patients recovering from addictions to heroin and other opiates.

A close-up of Newcastle pharmacist Kurt Strassmeir, wearing a button-up and blazer
Newcastle pharmacist Kurt Strassmeir says he doesn’t know where hundreds of patients will get care for opioid dependence if his service closes in the coming months.(ABC News: Ross McLoughlin)

“We see the patients come in at their worst point in their lives and to see them after a couple of months turn their lives around, keep their families together … it is quite rewarding.

“And to see all that work come undone within six weeks is devastating,” he said.

The pharmacist said the goal of the new policy is “fantastic”, but the private facilities have “slipped through the cracks”.

Stacks of green Suboxone Film boxes
The federal government says it’s investing $377 million to reform the Opioid Dependency Treatment Program, making medicines cheaper for patients.(ABC News: Mark Leonardi)

He called on the federal health minister Mark Butler to intervene.

“We need to keep our doors open and that requires Mr Butler’s immediate attention to fix and solve this crisis,” he said.

Clinics in Sydney, Newcastle and south-east Queensland at risk

Clinic 36 is a brick building with big blue doors
Clinic 36 co-owner Debbie Seidler has been dispensing medication for people with opioid addictions for over three decades.(ABC News: Sam Foster)

Debbie Seidler is the co-owner of Clinic 36 in central Sydney, which has been dispensing medication to people with opioid addictions for more than 30 years.

She said the impact on patients will be “catastrophic” if the changes are implemented next month and the facility has to close.

“To think that, in four weeks’ time, they would possibly have nowhere to go and get dosed is frightening and not what anybody would want,” Ms Seidler said.

Clinic 36 co-owner Debbie Seidler wears a spotty shirt in her office
Debbie Seidler says she doesn’t know where more than 400 patients will get their opioid addiction medication if her inner Sydney clinic closes next month.(ABC News: Sam Foster)

Her fellow owner, Keith Roberts, is a drug addiction specialist who worked in Kings Cross during the heroin wave in the 1990s.

“This change has not been properly thought through, our patients need proper care and respect and somewhere to be treated,” Dr Roberts said.

Clinic 36 co-owner Keith Roberts wears a button-up shirt in his office
Sydney drug addiction specialist Dr Keith Roberts has decades of experience treating people living with opioid dependence and says the reforms have not been “properly thought through”.(ABC News: Sam Foster)

Mr Pfeffer and other clinic owners have written to the health minister, the prime minister, MPs and senators.

“I note that most of the clinics are located in Labor Party electorates, including seats held by senior cabinet members.

“Following the closure of these clinics in four weeks’ time, there will be a sharp and sudden rise in illicit opioid use as patients are dislodged from their treatment.”

Pharmacist Andrew Pfeffer pours Aspen Methadone Syrup into a cup
Pharmacist Andrew Pfeffer owns a private clinic in Logan where health care workers prescribe and dispense opioid replacement medications.(ABC News: Mark Leonardi)

The health minister said some patients have been paying out-of-pocket private prescription fees of up to $150 a week.

“That is a huge impost for people who are dealing with very substantial health issues, many of whom are on income support,” Mr Butler told the ABC.

“I am working with the Queensland and New South Wales governments on a transition package that will ensure these clinics have a glide path that ensures as far as possible they are able to remain open.

“I make no apology for putting this medicine on the PBS, but I am very keen to make sure these clinics, which offer a range of important services beyond the supply of medicines, are able to keep operating and continue to provide those services.”

Advocate says more time is needed for implementation

Emma Kill with shoulder-length ombré hair, wearing a black shirt
Emma Kill said there are limited alternatives for those seeking support with opioid addiction.(ABC News: Stephen Cavenagh)

CEO of Queensland Injectors for Advocacy and Action (QuIVAA), Emma Kill, said the peak body “applauds” the government’s move to make the “life-changing and life-sustaining medications” more accessible under the PBS.

But she said the implementation “does require further time to ascertain the full impacts on private clinics and their patients”.

“A breakdown in continuity of care for this population can have serious and far-reaching consequences,” she said.

Ms Kill said there are limited alternative care providers.

“The system in Queensland is already overburdened and stretched beyond capacity,” she said.

Deputy CEO of the NSW Users and AIDS Association (NUAA), Charles Henderson, also welcomed “long overdue” efforts to make medicines cheaper.

Three blue boxes of Suboxone Film and an open pack showing the medication
Newcastle patient Sam said the reform could lead to “a big epidemic” if patients at private clinics have nowhere else to go.(ABC News: Mark Leonardi)

“In relation to the private clinics; we support the ongoing and current efforts at finding solutions, and much is in discussion and underway along the lines of making sure supply to clients is maintained,” he said.

Both Queensland Health and NSW Health highlighted the benefits of the reforms, but alluded to implementation issues.

“There are significant challenges and complex pressures on the delivery of opioid dependence treatment (ODT), not just in Queensland, but throughout Australia,” a Queensland Health spokesperson said.

“As such, we are advocating for a transition period that can support patient safety and continuity of care as well as allow services to adapt to these announced changes.”

A NSW Health spokesperson said the department “recognises the implementation changes” and is working with the Commonwealth, service providers and peak bodies “to ensure patients receiving opioid treatment continue to receive the care they need”.

*Name has been changed to protect privacy.

For information on treatment options in Queensland call the 24/7 drug and alcohol service ADIS on 1800 177 833.

For help in New South Wales call PeerLine on 1800 644 413 or head to the website.

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