ORT access and legislation

Prescriber and pharmacist notes for opioid replacement therapy in Australia. National PBS listing and MATOD guidance sit beside state and territory program rules. Confirm the linked official page before you prescribe or dose.

Summarised from Department of Health, PBS, and health-department pages. Each jurisdiction below records when that summary was last checked. This is a reading aid, not legal advice and not a protocol. Tap or click a superscript to open the source for that sentence.

Opioid replacement therapy is the supervised use of a long-acting opioid — methadone, buprenorphine, or buprenorphine with naloxone — to treat opioid dependence. Jurisdictions also call it opioid substitution treatment, opioid pharmacotherapy, the Opioid Treatment Program, Medication Assisted Treatment for Opioid Dependence, or opioid maintenance treatment. The medicines are Schedule 8. Who may prescribe or dose, and under what permit, is set by state and territory poisons law on top of national clinical guidance and PBS listing.

The national clinical map is the Department of Health’s guidelines for medication-assisted treatment of opioid dependence. Those guidelines describe agonist pharmacotherapy with methadone or buprenorphine, plus psychosocial support. They are not a substitute for the current jurisdictional program rules, product information, or a real-time prescription-monitoring check.

From 1 July 2023, PBS opioid-dependence treatment medicines sit in the Section 100 Highly Specialised Drugs Program (Community Access). Eligible patients can obtain methadone liquid, buprenorphine sublingual tablets, buprenorphine–naloxone films, and listed injectable buprenorphine from a PBS-approved supplier. At a section 90 community pharmacy, patients pay the usual PBS co-payment and must not be charged an extra private dispensing or dosing fee. Staged-supply and injection-administration fees for the pharmacy are claimed separately, and only where the pharmacy is authorised by its state or territory to supply these medicines.

This page summarises official public guidance as at September 2026. It is not legal advice and it is not a dosing protocol. If a linked department page has moved, follow that page.

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Commonwealth (PBS and national guidelines)

National clinical guidance sits beside PBS Section 100 Community Access listing. State and territory programs still decide who may prescribe and which pharmacy may dose.

Medicines in the program

PBS opioid-dependence treatment currently covers methadone oral liquid, buprenorphine sublingual tablets, buprenorphine with naloxone sublingual films, and buprenorphine modified-release injections. Supply is through section 90 community pharmacies, section 92 approved medical practitioners, and section 94 hospital authorities. A prescription written after 1 July 2023 must meet PBS requirements to be claimed on the PBS.

Community pharmacy program

A separate Opioid Dependence Treatment Community Pharmacy Program pays participating section 90 pharmacies for staged supply (supervised and take-away dosing) and, where jurisdictional rules allow, on-site pharmacist administration of injectable buprenorphine. Hospital pharmacies are not eligible for those community-pharmacy service fees. Written patient consent is required before claiming under that program.

Last checked September 2026. For more detailed information see: PBS Opioid Dependence Treatment Program.

New South Wales

The NSW Opioid Treatment Program requires registration to prescribe, supply, or administer methadone or buprenorphine. Standard-treatment notifications and non-standard approvals run through SafeScript NSW.

Prescribers

Medical and nurse practitioners who complete the Fundamentals of Training and the Opioid Treatment Accreditation Course become accredited OTP prescribers. A NSW medical practitioner who is not accredited may still be authorised to manage up to 30 patients: a maximum of 10 on methadone referred by an accredited prescriber, and a maximum of 20 on buprenorphine or buprenorphine–naloxone. Authority from NSW Health must be granted before a prescription is issued to start treatment. Standard treatment is methadone 200 mg per day or less, or buprenorphine 32 mg per day or less; doses or medicines outside that range need prior approval.

Pharmacists

A community pharmacy must hold OTP registration with the Pharmaceutical Services Unit before it can order or supply methadone or buprenorphine under the program. Dosing at a community pharmacy requires a prescription. Take-away doses must be dispensed by a pharmacist. Pharmacists can view OTP approval history, dose, and dosing-point details in SafeScript NSW, and should contact the prescriber if the prescription or patient circumstances raise concern.

Last checked September 2026. For more detailed information see: NSW OTP — medical practitioners, NSW OTP legislative requirements, and NSW OTP — pharmacists.

Victoria

Victoria calls the program pharmacotherapy, or opioid replacement therapy. Medical practitioners, nurse practitioners, and community pharmacies apply for approval to prescribe or dispense. A patient-level permit is still required to treat opioid dependence with methadone or buprenorphine.

Prescribers

Medical or nurse practitioners may prescribe buprenorphine/naloxone or long-acting injectable buprenorphine for up to ten patients without MATOD training. Completing RACGP MATOD training is required to increase those numbers or to prescribe methadone. Approved practitioners apply for a permit to treat an opioid-dependent person through the department’s online drugs and poisons forms. The department must be told if a patient is terminated from a program.

Pharmacists

Community pharmacies apply for approval as a pharmacotherapy dispenser. The department publishes a pharmacist self-assessment against key regulatory and policy requirements for lawful ORT supply. Pharmacist training is available through the Pharmaceutical Society of Australia. Victoria allows pharmacists to dispense pharmacotherapy prescriptions written by interstate prescribers; the rules for those interstate prescriptions differ by originating jurisdiction. Methadone and buprenorphine remain SafeScript medicines.

Last checked September 2026. For more detailed information see: Victoria — pharmacotherapy (ORT), Victoria — pharmacotherapy training, Victoria — pharmacotherapy forms, and Victoria — SafeScript.

Queensland

The Queensland Opioid Treatment Program covers methadone, buprenorphine-mono, buprenorphine–naloxone, and long-acting injectable buprenorphine. Prescribing those approved opioids requires a prescribing approval. QScript checks apply before supply.

Prescribers

Medical practitioners and nurse practitioners can prescribe through QOTP. Methadone, buprenorphine, and buprenorphine/naloxone used for opioid dependence are restricted medicines: a prescribing approval is required. Queensland Health sets mandatory training modules — understanding opioid dependence; buprenorphine–naloxone and long-acting injection buprenorphine; and buprenorphine-mono and methadone. The prescription must include the prescribing-approval number, the dosing site, how doses are to be given, and start and end dates.

Pharmacists

QOTP medicines are monitored medicines. Relevant practitioners must check QScript before supplying unless an exemption or reasonable excuse applies, and community dispensers must upload monitored-medicine records in real time through a prescription delivery service. Queensland Health also publishes a fact sheet on pharmacist administration of long-acting injectable buprenorphine.

Last checked September 2026. For more detailed information see: Queensland Opioid Treatment Program, Queensland — prescribing monitored medicines, and QScript legislative requirements.

Western Australia

Western Australia runs the Community Program for Opioid Pharmacotherapy. Only authorised medical practitioners may prescribe opioid substitution treatment, and each patient needs a written authorisation before dosing starts.

Prescribers

Prescribing methadone or buprenorphine as opioid substitution treatment is restricted to authorised medical practitioners in CPOP. Written authorisation is required before prescribing to any patient. Prescribers apply to become authorised after completing Community Pharmacotherapy Program training, and must be reaccredited at intervals. Practitioners are authorised for a maximum number of patients at any time; higher numbers need extra departmental approval. Only one practitioner is authorised to prescribe CPOP for a patient at a time. The Monitored Medicines Prescribing Code applies. Prescriptions must be valid Schedule 8 orders and include the Health Department authorisation number, exact daily dose, nominated pharmacy, start and finish dates, and any unsupervised take-away doses.

Pharmacists

Patients must be directed to an authorised CPOP pharmacy for observed oral dosing and, where used, depot administration. The Community Pharmacotherapy Program supports participating pharmacies. Ordinary Schedule 8 prescription and ScriptCheckWA duties still apply.

Last checked September 2026. For more detailed information see: WA Health — opioid substitution treatment and WA Health — medicines and poisons regulation changes.

South Australia

South Australia’s program is Medication Assisted Treatment for Opioid Dependence. Daily supervised dosing at a pharmacy or clinic is the usual model. Accreditation is required to prescribe methadone or to exceed the limited non-accredited buprenorphine caseload.

Prescribers

All medical practitioners and nurse practitioners, within scope, may prescribe sublingual buprenorphine with naloxone film for up to ten patients without specialised MATOD training. Accredited MATOD prescribers apply to the Drugs of Dependence Unit for authority to prescribe methadone or other buprenorphine products. Non-accredited prescribers need DDU approval for listed exemptions, and must complete the department’s depot-buprenorphine theory module before prescribing depot injections. MATOD prescriptions should state the dose in milligrams (and millilitres for methadone), supervised versus take-away doses, expiry, and the named pharmacy.

Pharmacists

From 10 June 2025, South Australian pharmacists may administer long-acting injectable buprenorphine. No extra SA Health approval is required for that administration, but the pharmacist must work to the published practice standards and may only inject on a legally valid prescription that names that pharmacy as the only site authorised to dispense and administer the injection. It is lawful under the Controlled Substances Act 1984 for a pharmacist to administer a Schedule 8 medicine that has been lawfully prescribed for that patient.

Last checked September 2026. For more detailed information see: SA Health — MATOD regulatory information, SA Health — prescribing drugs of dependence, and SA Health — community pharmacy MATOD.

Tasmania

Tasmania’s Opioid Pharmacotherapy Program supplies opioid replacement therapy through Alcohol and Drug Service clinics, some general practitioners, and community pharmacies. A pharmacy must be approved before it can order methadone or buprenorphine for the program.

Prescribers

Opioid replacement therapy is provided by Alcohol and Drug Service doctors and case managers, and by some general practitioners. Suboxone is generally the gateway medicine into treatment. Depot buprenorphine has been available in Australia since 2018. Clinical delivery is set out in the Tasmanian Opioid Pharmacotherapy Program policy and clinical practice standards — confirm that document before changing a patient’s program.

Pharmacists

To supply ORT under the program a pharmacy needs Alcohol and Drug Service Pharmacy site approval. Buprenorphine and methadone ORT products cannot be ordered from a supplier until that approval is completed. Most dosing is by community pharmacists. Pharmacist administration of depot buprenorphine is a separate authorised activity: training, a supervised practicum, and ADS authorisation are required under the department’s depot policy.

Last checked September 2026. For more detailed information see: Tasmania — opioid pharmacotherapy program and Tasmania — ORT information for health professionals.

Australian Capital Territory

Prescribers need Chief Health Officer approval to prescribe opioid maintenance treatment to a drug-dependent person. Community pharmacies need an Opioid Dependency Treatment Centre licence before they can dose.

Prescribers

CHO approval is required for each drug-dependent patient. Non-endorsed prescribers may obtain approval to continue maintenance therapy for up to five patients already established on methadone, buprenorphine, or buprenorphine/naloxone. Prescribers who want to induct new patients or treat more than five need endorsement to treat drug dependency, including designated training, an examination, and a practical placement. Category 3 approvals cover liquid methadone and sublingual or depot buprenorphine, and must be prescribed in line with the national MATOD guidelines.

Pharmacists

A community pharmacy must hold an Opioid Dependency Treatment Centre licence to dispense methadone, buprenorphine, or buprenorphine/naloxone for drug dependence. The person dosed must acknowledge the medicine name, form, strength, quantity, and date. Dispensing should follow the national MATOD guidelines and, where possible, the ACT local opioid-maintenance procedures. Staff involved in dosing must complete the training those guidelines set out.

Last checked September 2026. For more detailed information see: ACT — opioid maintenance treatment and ACT — opioid treatment centre licence.

Northern Territory

Methadone liquid, sublingual buprenorphine, buprenorphine/naloxone, and buprenorphine depot injections are restricted Schedule 8 substances when used as pharmacotherapy. A Chief Health Officer authority is required for each patient before a prescription is written.

Prescribers

Medical practitioners providing pharmacotherapies for opioid dependence need to complete approved training and show continued clinical involvement and refresher training. An authority from the Chief Health Officer to supply buprenorphine, buprenorphine/naloxone, buprenorphine depot injections, or methadone is required for each individual patient before a prescription can be written or supplied. The framework also covers period of supply, dispensing, and take-away privileges.

Pharmacists

Ordinary Northern Territory Schedule 8 dispensing, storage, and record rules apply to these restricted substances. Confirm current pharmacist and take-away requirements with NT Medicines and Poisons Control rather than importing another jurisdiction’s dosing protocol.

Last checked September 2026. For more detailed information see: NT — medical practitioners and Schedule 8 medicines and NT Health — medicines and poisons.

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Educational information only. It is not a diagnosis, prescription, or a substitute for advice from a registered health practitioner.