HRVic's PAMS service provides info and help with and around Methadone/Suboxone/Subutex programs in Victoria PAMS Pharmacotherapy Advocacy Mediation Support A phone service that assists with methadone / Suboxone / long-acting bupe injection (Buvidal / Sublocade) issues between clients and prescribers and dispensers. FREE CALL 1800 443 844 HRVic's PAMS service is Victoria's only pharmacotherapy advocacy and mediation service. PAMS is a telephone service ONLY. You will need to call the PAMS phone line if you have any enquiries or issues that are not in the Client or Providers FAQ sections. Please note: As we are a state-wide phone service, please be patient- you may get the answering machine when you call. If you do- PLEASE LEAVE A MESSAGE -include your first name, and a short message about your issue and a CONTACT number we can reach you on. *If your issue is URGENT, or you are calling from a prison or detention facility where a call back is difficult, please state that in your message along with a time you will call back or we can call you. Please do not keep calling if you get the answer machine as this only takes up our time checking messages when we could be calling you or someone else back. PAMS is a confidential service – we do not discuss you or your situation with any other party without your consent. (As we are a telephone service, consent is, in most cases, provided verbally.) CLIENTS New or Existing Patients SERVICE PROVIDERS Prescribers / Dispensers WHAT IS PHARMACOTHERAPY? Pharmacotherapy, when used with regard to substance use refers to the replacement of a person’s drug of dependence with a legally prescribed and dispensed substitute. HISTORY OF PAMS The information provided here is for people whose opioid dependency has currently become problematic or unmanageable for them. The most commonly used opioids in Australia today are prescription formulations (codeine, oxycontin, morphine, fentanyl, etc), illicit opioids such as heroin, and the pharmacotherapy medications methadone and buprenorphine. All opioids have the potential to produce physical dependence. Pharmacotherapy for opioid users is sometimes referred to as Opioid Replacement Therapy/Treatment (ORT), Opioid Pharmacotherapy Program (OPP), or Opioid Substitution Therapy/Treatment (OST) and now Medically Assisted Treatment for Opioid Dependency (MATOD). Though maybe not for everyone, many find that pharmacotherapy has the ability to stabilise their condition, allowing them to devote more time to managing or repairing their lives. Once stabilised, clients may find they wish to strive for a drug-free existence by slowly reducing their dosage – or else they may be satisfied with a maintenance program and stay stable. Pharmacotherapy has been found to reduce opiate-related harm to both the individual and society. Though other treatments exist (cognitive behavioural therapy(CBT) , drug detoxification and (rehab) treatment centres etc., being on a pharmacotherapy program is at present our most effective answer to the problems associated with opioid dependence. Pharmacotherapy programs are available throughout most of Australia. However, each state or territory has its own pharmacotherapy policy and programs can vary considerably. CLICK HERE for PAMS During COVID19 INFO PHARMACOTHERAPY CURRENTLY AVAILABLE IN VICTORIA (AUSTRALIA) There are four different pharmacotherapy drugs available in Victoria. Each has it's own advantages and disadvantages. When deciding with your doctor which is right for you, it may be helpful to check out our fact sheets below: METHADONE Methadone Syrup , Biodone Forte (liquid) Physeptone* (tablet) *Only available for travel SUBUTEX Buprenorphine (sublingual tablet) SUBOXONE Buprenorphine / Naloxone (sublingual film) NALTREXONE (tablet, subcutaneous implant, injection) BUVIDAL™/ SUBLOCADE™ Depot Buprenorphine (long acting buprenorphine injection) VICTORIA REASONS TO CALL PAMS: • you can’t get a dose or a number of doses • you have been told to get a new prescriber or pharmacy due to a problem • you feel you have been discriminated against or treated unfairly by your pharmacist or GP • are thinking of starting or resuming a pharmacotherapy program and have any questions or there is a problem or concern you are travelling inter-state or overseas and are on a pharmacotherapy program and need more information travelling OR If you are a prescriber or dispenser in need of information or advice, on ANY client related issue or concern All calls are entirely confidential. PAMS is a free, partially government-funded service. HOURS OF OPERATION PAMS is open from 11 am – 5 pm, Monday – Friday. INTERSTATE PHONE: PH: 03 93291500 or Email us: pams@hrvic.org.au NB: Email enquiries MAY take up to 72 hours for a response as we prioritise telephone enquiries. *Please note that our 'free-call' number is unfortunately NOT free from mobile phones. If you are calling from a mobile, let us know and we will call you straight back. OTHER STATES PHARMACOTHERAPY SERVICES NOT IN VICTORIA? If you are NOT in Victoria and you have a problem with your program, your local your state or territory drug-user organisation may be able to help you. QLD – Queensland Pharmacotherapy Advocacy Mediation & Support Service (QPAMS) PH: 1800 175 889 – a program of the Queensland Drug User Organisation (QUIVAA) WA – Opiate Replacement Pharmacotherapy Advocacy and Complaints Service ( ORPACS) PH: (08) 9321 2877 – a program of the WA Drug User Organisation (WASUA) NSW – MACS a program of Rankin Court (public clinic) PH: 1800 642 428 SA- DASSA Drug & Alcohol Services SA PH: 1300 13 1340 Check the AIVL (the national drug user organisation) website or phone AIVL directly on 02 62791600 for more info on your state.

HRVic's PAMS phone service provides info around & help with methadone or suboxone or Subutex programs in Victoria Top of Page FOR PEOPLE ON OR STARTING PHARMACOTHERAPY (METHADONE (liquid), SUBOXONE (bupe/naloxone), SUBUTEX(bupe), or BUVIDAL, SUBLOCADE (long acting bupe injections) HRVic's PAMS service has access to the latest pharmacotherapy information. ALREADY ON TREATMENT? How PAMS can help you: CHOOSE ONE I AM CURRENTLY TAKING PHARMACOTHERAPY (methadone / bupe / suboxone / long acting injectable bupe) NOT ON TREATMENT YET? I AM THINKING ABOUT STARTING or I WANT TO START TAKING PHARMACOTHERAPY FAQs Frequently Asked Questions We strongly encourage you to call us PH: 1800 443 844 so that we can make sure we thoroughly understand your situation. Scroll over the questions to reveal their answers CURRENTLY NOT AVAILABLE ON PHONES What is Suboxone? Suboxone is a combination of buprenorphine with naloxone. Suboxone comes in the form of a tablet and a dissolvable film that is placed under the tongue. What is buprenorphine? Buprenorphine is a synthetic opioid that produces weaker euphoric effects than say, heroin or methadone but it reduces or eliminates your symptoms. What is methadone? Methadone a powerful synthetic analgesic drug which is similar to morphine in its effects but less sedative and is used as a substitute drug in the treatment of morphine and heroin dependence. How many methadone take away doses (TADs) can I get? Usually 4, but COVID 19 has had a positive effect on take aways giving most clients up to 6 TADs a week. Personal Shoppers I've been told I can't be dosed at my pharmacy anymore. Are they allowed to do this? Yes. Pharmacies are private businesses. They do not have to provide a service to anybody, regardless if the person is on a pharmacotherapy program. Easy Returns My pharmacist refuses to dose me unless I have the money to pay for it? Is this legal? What can I do? Yes. Your pharmacist doesn't have to dose anyone who can't pay for it. If you need help with this, please call PAMS and we can try to work out a payment plan for you. Easy Returns My doctor has told me that I have to find another prescriber. Don't they need to find me a new one if they can't prescribe? Generally, if a GP bans a client from their practice- and YES they CAN DO THAT- they will make sure the person has a script to cover them for at least a week. Finding a new prescriber can be hard, contact PAMS as soon as you know you need a new GP and we can try to help. Easy Returns I have to go to court tomorrow and I will need another take away dose, Can my pharmacist just give me one extra? If you have used your prescribed take aways for the week, you will need to get your prescriber to add another T/A dose for this week. Make sure you ask BEFORE your court date. Some GPs will do this over the phone to the pharmacist-some won't. Easy Returns I have missed two doses this week. My script says I can have 4 take aways per week but my pharmacist is now refusing to give me any , What can I do? It is best to talk with your doctor about this. If you need help with this, please call PAMS and we can try to advocate for you. Some things to consider before going on 'the program'. The decision to start pharmacotherapy is often made in a state of crisis- in a rush, with little thought given to the long term consequences. Ask yourself a few things before taking the leap – particularly if you have not been on a pharmacotherapy program before. Is this your decision or do you feel pressured by others? Is there threat of incarceration or the removal of children? Is the program part of your parole or CBO conditions? If it’s not your decision, this may influence your chances of success. Is this the best treatment option for you at this point in your life? Why? Do you know about the different pharmacotherapy options ie. Methadone or Suboxone or long acting bupe injection? Do you know which is likely to suit you best and why? Are you aware of the alternatives to pharmacotherapy such as a detox program either at home or as part of a residential program? If you have tried the alternatives and they did not work, Why? Are you prepared to make a long term commitment? Pharmacotherapy usually works best as a long-term commitment. How long do you expect your pharmacotherapy program to last? Do you have to travel for work or regularly? It is still possible to travel (almost anywhere) when on a program, but it does mean you need to organise things in advance. Do you know about the different pharmacotherapy options ie. Methadone or Suboxone or long acting bupe injection? Do you know which is likely to suit you best and why? Are you aware of the commitments involved like visiting a GP at least monthly and a pharmacy every day (in the first few months)? Can you afford the dispensing fee (approx. $7.30 per 28 day prescription(w/ Health Care card) or $30(without)? Could you get to a pharmacy every day if it was required by your prescriber? Will picking up your daily dose interfere with your employment, family commitments, study etc? Are there service providers (doctor & pharmacist) near where you live and do they have vacancies ? Unfortunately, NOT ALL GPs will prescribe pharmacotherapy. This can be a particular problem if you live in a regional/rural area. Are you involved in any other type of drug treatment at present? (for example individual counselling) Have you spoken to others on a program? Although everybody’s experience is different, it can be extremely helpful to talk to your peers and ask them how the program works for them. Do you feel well informed? If the answer is yes, and you have decided to embark on a pharmacotherapy program, it is time to act.

WHACK magazine is HRVic's flagship publication. 37 Issues and 30 years deep, made by drug users for drug users. GET IT AT YOUR LOCAL DRUG USER FRIENDLY SERVICE, NSP OR CLINIC OR COME GET IT FROM THE HRVIC OFFICE! WHACK Magazine is HRVic’s FREE educational and informational community zine. A zine written for and designed BY people who use drugs FOR people who use drugs. WHACK is not for public consumption or sale. WHACK Magazine WHACK is an integral part of Victoria's community of people who use drugs. Our mission to advance the health and human rights of people who use drugs by sharing information, supporting and empowering each other. Currently WHACK magazine comes out, IN PRINT ONLY, EVERY QUARTER - Spring, Summer, Autumn and WInter. Due to increases in printing and postage prices and staff workloads, HRVic does it's best to keep to this timeline but can occasionally be held up. Please be patient when ordering more WHACKs for distribution and consider our back catalogue if you've run out. By providing our community with a free platform to be able to express our thoughts and feelings and that delivers factual, relevant information about issues that directly relate to our lives including up to date information about substances, and reducing the harms associated with drug use – in particular reducing the risk of HIV, hep C and hep B. Due to the diverse & marginalised nature of our community, we do our best to present the info in such a way as to have wide appeal & lasting impact & to represent the different perspectives of a wide range of contributors – from peers to researchers to carers and allies to workers and back to peers.. The information takes on an array of forms- from the informative to the ridiculous – and everything in between. We are constantly on the search for new ways to share our harm reduction messaging and to extend the reach of that message- all while staying true to our roots. HOW TO SUBMIT TO WHACK Send images or stories to samj@hrvic.org.au Back Issues - Late 1980's to TODAY! We are 50 magazines deep! The library of FREE community made magazines you see before you represents the vast body of work that HRVic’s dedicated community have created over the last 30 years plus! Back issues of the magazine are available to read in person in our library in HRVic's Community room at 299-305 Victoria St Brunswick Vic. We can provide you with a pdf of stories if you know what you are after. WHACK magazine is NOT for PUBLIC CONSUMPTION OR FOR SALE.

! !**DRUG ALERT**!! (Melbourne/Naarm, Victoria, and VIC wide) !!**COCAINE adulterated with opioid PROTONITAZENE**!! A white powder sold as cocaine in Melbourne has been found to contain the potent synthetic opioid 'protonitazene'. There have been recent serious harms in Melbourne/Naarm associated with a 'white powder' sold as COCAINE that contained the potent opioid PROTONITAZENE. The product appears to produce strong adverse effects such as loss of consciousness, respiratory depression, and life-threatening hypoxia. (lack of oxygen in your blood) Protonitazene is faster acting and is much stronger (100x) than heroin. It is important for everyone- REGARDLESS of the substance you are planning to take- to CARRY NALOXONE. **CARRY iT ON YOU!!- not keep in a cupboard at home or your glove box in the car. It could mean the difference between life and death for someone. Naloxone is a FREE, easy-to-use, easy to get medication that can temporarily reverse an opioid overdose – it is safe to use even if you are not sure whether someone has taken opioids. HRVic does FREE naloxone administration training EVERY 1st of the month. Naloxone can be accessed at HRVic's NSP and at participating pharmacies, other needle and syringe programs and from the medically supervised injecting centre. You can find an approved naloxone provider on the Take Home Naloxone program webpage. ( https://www.health.vic.gov.au/.../victorias-take-home ... ) Protonitazene is one of the many NITAZENES that have been circulating throughout Australia over the past couple of years. Read more about the types of Nitazenes and their effects in the latest WHACK magazine OUT NOW at your local NSP. Read the Nitazenes substance specific article here: If you are an HRVic Member and have not yet received a copy in the mail, email us at info@hrvic.org.au to UPDATE YOUR MEMBERSHIP. If you have any questions or want more info visit the Dept of Health alert : https://www.health.vic.gov.au/.../cocaine-adulterated ... or HRVic's Overdose page on our website: www.hrvic.org.au/dope

A pink and white capsule sold as ‘3C-P’ in Melbourne/Naarm contains the potent opioid protonitazene. The Department of Health has issued a new Drug Alert about a pink and white capsule or white powder sold as ‘3C-P’ or in Melbourne containing the potent opioid protonitazene. Opioids are central nervous system depressants, typically producing a range of effects including pain relief, sedation and respiratory depression (dangerously slow breathing). Respiratory depression often appears more quickly with novel synthetic opioids (NSOs), increasing the risk of life-threatening overdose. Protonitazene is an extremely potent NSO, which means it can produce strong effects in very small amounts. There has been one serious recent hospitalisation in Victoria associated with this pink and white capsule. Due to the potency of NSOs, the product produces strong adverse opioid effects such as loss of consciousness, respiratory depression, and life-threatening hypoxia (insufficient oxygen for normal functioning). It’s important to know the signs of opioid overdose and to carry naloxone to reverse opioid overdose-even if you don't plan to take opioids. HRVic has naloxone available for FREE from our NSP at 299-305 Victoria St Brunswick. We also have naloxone training EVERY 1st of the month ONLINE for FREE at 4:30pm. See website for details (www.hrvic.org.au/training) We can also do one on one training with you if you don't know how to use, when you come to pick up. Or check out our info on naloxone on our 'Recognise & Respond to Overdose' page. Anyone who experiences adverse drug effects or is present when someone has an unexpected reaction to a drug should seek help immediately by calling Triple Zero (000). See DoH drug alerts here: https://www.health.vic.gov.au/.../protonitazene-sold-as-3c-p