Methadone and buprenorphine prescribing patterns of Victorian general practitioners: their first 5 years after authorisation.

INTRODUCTION AND AIMS: The use of opioid substitution therapy (OST) is a widely used and effective treatment for opioid dependence, yet many Australian general practitioners (GPs) authorised to administer OST, prescribe to very few or no patients. This is a particular issue within Victoria that places greater reliance on a small number of active OST prescribing GPs, compared with other jurisdictions. Given the unmet demand for treatment, the provision of accurate figures on the OST prescribing practices of Victorian GPs is necessary for workforce planning. This study aimed to ascertain information on the prescribing patterns of Victorian GPs in their first 5 years after training, and elicit any trends that may explain their reluctance to prescribe OST.

DESIGN AND METHODS: The prescribing patterns over a 5 year period of 168 Victorian GPs who became first authorised to prescribe OST during the years 2001-2004 were examined by accessing the Victorian Department of Human Services OST individual patient treatment permit data.

RESULTS: Forty-six per cent of these GPs never held a patient permit, and at any one time, approximately two-thirds did not hold a permit. The majority of active prescribers were treating fewer than 10 patients and only 12.5% ever prescribed to more than 50 patients.

DISCUSSION AND CONCLUSIONS: The study suggests the Victorian GP workforce is inadequate to address the demand for OST. Many more GPs will need to be recruited, and encouraged to prescribe for more patients. Further research is required to identify barriers to GP OST prescribing.