Medication Assisted Treatment for Opioid Dependence – Position Statement

Purpose

This position statement sets out Department of Justice and Community Safety (DJCS) expectations for delivery and access to Medication Assisted Treatment for Opioid Dependence (MATOD) and replaces the Victorian Prison Opioid Substitution Therapy Guidelines 2015, the Justice Health Long-Acting Injectable Buprenorphine (LAIB) Practice Guidelines 2021 and the Justice Health Medication Assisted Treatment for Opioid Dependence (MATOD) Interim Practice Instruction, which are now rescinded.

Scope

All adult and youth custodial settings in Victoria including actively facilitating continuity of care into community based MATOD treatment.

Position statement

People in custody have access to treatment for opioid dependence and/or withdrawal, while they are in custody upon provision of informed written consent (or verbal consent in exceptional circumstances only, when written consent is not possible). Access to treatment will be clinically determined and aligned with evidence-based best practice. The decision to commence MATOD by the treating practitioner will be made after consideration and discussion of the risks and benefits with the individual and if indicated, in consultation with other health staff members actively involved in the individual's care.

Access to treatment will only be withheld or withdrawn when it is no longer considered clinically appropriate or safe (e.g. due to side effects, interaction with other medications etc) or where non-compliance presents a clinical risk. Custodial staff will actively support people in custody to access treatment and implement measures to maintain the safety and security of the custodial facility including to reduce the risk of diversion. Health staff will actively facilitate continuity of care on transfer to other custodial facilities or into the community for the health and wellbeing of people accessing MATOD.