COVID-19 Pharmacotherapy Update from the PAMS Service The PAMS Service will continue to operate during COVID-19. You can contact us by calling 1800 443 844 , (free call from landlines, most mobiles, and all public phones). During the last 4 weeks or so, we have had several calls from pharmacotherapy consumers who are worried about various aspects of the program, given the international COVID-19 pandemic. We would like to reassure people on methadone or buprenorphine (Subutex) or buprenorphine-naloxone (Suboxone) that: the supply of these medications can be guaranteed in Australia for the foreseeable future. Pharmacies are ‘essential services’ and are therefore likely to remain open during COVID-19. Importantly, all pharmacotherapy dispensing pharmacies have been encouraged to have plans in place in order to ensure ongoing service delivery in the event the pharmacy had to close for a short period (e.g. due to staff sickness). PAMS has developed “Some Helpful Tips for People on Pharmacotherapy Programs”. Given information is changing rapidly during the COVID-19 pandemic, we have now updated and added to our “helpful tips” which can be found here. What has changed for Victorian Pharmacotherapy Consumers as a Result of COVID-19? New COVID-19 Specific Pharmacotherapy Guidance: In consultation with several experts, (including PAMS), the Department of Health and Human Services (DHHS) have released an interim guidance which aims to make life safer for Victorian pharmacotherapy consumers and service providers during COVID-19. Currently, this guidance is in place only in response to COVID-19 and may be removed after the pandemic eases. Take-Away Doses, (TAD): We all know we are being encouraged to “stay at home” as much as possible during COVID-19. The less contact we have with other people, (e.g. on public transport, at the pharmacy or in the street), the safer we and our loved ones are likely to be. Given this interim guidance is now in place, some people might be eligible for TADs for the first time and others may be able to get additional TAD’s. The new (COVID-19 specific) Victorian TAD policy can be found here. A tool has been developed to help prescribers assess patient eligibility for TADs during COVID-19 which can be found here. Contra-indications to TADs: Please remember that both your pharmacist and prescriber must be in agreeance before you can get TADs or additional TAD’s. There are 4 circumstances when it is not considered safe to have TADs, these are: Recent OD reported with any substance Recent diversion of doses to others, sharing or trading of doses No safe and secure storage facility available Serious and immediate risk of harm to self or others Talking to your prescriber and pharmacist about TAD’s/extra TADs: If you feel you would benefit from a TAD review, PAMS staff suggest you consider the following: Get yourself a safe, secure storage facility: this can be as simple as finding a secure place, (e.g. a locked drawer or filing cabinet) where your TADs can be safely stored away. If your TADs are stored safely: You are unlikely to lose your dose/doses if your accommodation is burgled, Your confidentiality is maintained regarding the program and family members/non-using friends Your doses are kept safe from children and even pets! There is much less chance of an accidental, methadone-related overdose occurring. Remember: having a safe, secure storage facility is a requirement for TADs. Talk to your pharmacist first – ask if they would be happy to dispense TADs or additional TADs before you talk to your prescriber, (getting the support of your pharmacist is essential). Do the “check-list for assessing appropriateness of TAD’s to support continuity of pharmacotherapy during the COVID-19 pandemic” yourself first. This will give you a good idea of what your prescriber might consider when faced with this question. The checklist can be found here. Talking to your prescriber: think about the points you want to get across to your prescriber regarding TAD’s and why you feel you would benefit from them. Do you have any other chronic conditions that might make you more at risk of COVID-19 (e.g. history of respiratory problems, immune compromised, living with elderly relatives, are you over 60 years etc). Do you have to travel to the pharmacy on public transport, do you live in rural/regional Victoria with no car and public transport has been reduced etc. When talking to your prescriber, try not to demand what you want, instead try to explain the problem, and ask for their input and opinion. Importantly, maintain your cool, getting angry just makes everything worse for everyone! 3rd Party Pick-up: A formalised arrangement is now in place whereby if you must isolate or are unwell and therefore unable to present for an in-store dose, it is now possible to have your dose/s collected by another, (officially authorised) person, referred to as a ‘3rd party’. If you find yourself possibly needing a ‘3rd party pick-up’, you may want to consider the following questions: Who should I choose to collect my dose/s? The ‘3rd party’ needs to be somebody you trust (if it is a person you know). Importantly, there is a requirement the ‘3rd party’ has photo ID. If you do not have a family member or friend who is appropriate to collect your dose/s, then the next option would be to ask a case worker (if you have one), failing this it is possible to utilise a courier company. Importantly, both the prescriber and pharmacist will need to approve of the 3rd party you have nominated. Will there be any additional costs to me? Any doses collected by the ‘3rd party’ must be dispensed by the pharmacist as a TAD/s. In some instances, pharmacists charge additional fees for dispensing a TAD (e.g. for a bottle). We would hope there would not be any further cost to the consumer, aside from the usual dosing fees. However, if a courier company is used, they will likely charge a fee for service. What, (if any) changes need to be made to my script? Your pharmacotherapy prescription will need to reflect a TAD for each dose to be collected by the 3rd party. As an interim measure this could be a verbal authorisation from the prescriber to the pharmacist, however an actual prescription will need to be supplied as soon as practicable. How are the doses transported from the pharmacy to me? It is essential for the ‘3rd party’ to understand the need to collect the dose/s from the pharmacy and transport them directly to you, the consumer. Doses should, (ideally) be transported by car as opposed to public transport wherever possible. Under no circumstances should your doses be left unattended, (e.g. in a car) for any period. Who signs for the doses and how does this process happen? Your doses will need to be signed for at the pharmacy by the 3rd party. Are there any forms that need to be completed? There are forms available to assist with 3rd part pick-up. Although not mandatory, these documents can assist to formalise the 3rd party pick-up process and outline the various roles and/or responsibilities of all parties involved. These forms can be found here. We refer to the issue of ‘3rd party pick-up’ when we discuss “what do I do if I have tested positive or need to isolate”, which can be found here. The actual guidelines on 3rd party pick-up can be found here. Prescription Length: Once you are stable on a program, most prescribers write a pharmacotherapy prescription for a month. However, during COVID-19, prescribers are being encouraged to write prescriptions for up to 6 months. There are a few reasons for longer pharmacotherapy prescriptions during COVID-19, including: If your prescriber became unwell, (e.g. had to self-isolate) and there was nobody to write your prescription from the same clinic, a longer script would hopefully allow your prescriber enough time to recover. Providing you do not miss 4 doses in a row, you can likely continue to dose. Hopefully, if your prescriber is seeing less patients face to face due to longer prescriptions, they are less likely to become unwell, Reduced travel to medical appointments, means overall less exposure to other people e.g. on public transport and/or inside the clinic. Remember, if you do get a longer script it is likely your prescriber may want to have regular check-ins with you, (these can now be done over the phone or by videoconferencing – see below). Tele-health: Pharmacotherapy prescribers can now bulk-bill patients through Medicare for consultations by phone or videoconference, (tele-health). In relation to tele-health, PAMS suggest that you consider the following: Before your next medical appointment, contact your prescriber’s clinic to find out if they require you to attend in person or if they offer tele-health. If your preference is for tele-health and it is offered by your prescriber, ask if there is anything you need to do, (e.g. is there an application you need to download for a videoconference or tele-health consult?) Make sure that your medical clinic have your recent contact details, (mobile phone number, email address and next of kin/emergency contact), store the clinic phone in your mobile phone so you will know if they are calling you. Before the tele-health consultation ends, ask your prescriber for the date your prescription expires and when the next consult will be – make sure you have these dates recorded somewhere safe. If there is anything that worries you about using tele-health, (e.g. your privacy/confidentiality, understanding of and/or availability of technology etc), please raise these issues with your medical clinic or pharmacotherapy service provider. What do I do if I think I might have COVID-19 or may be required to self-isolate? Opioid Withdrawal and COVID-19: Some of the symptoms of COVID-19 can be a little like opioid withdrawal, therefore it is important not to jump to any rash conclusions. If you are on a program and think you might have COVID-19 or may be required to isolate, we suggest you follow the steps below, including: Call the COVID-19 hotline, (PH: 1800 675 398) – they will advise if you need to be tested and provide information on test sites etc. NEGATIVE COVID19 TEST RESULT - Nothing needs to change POSITIVE COVID19 TEST RESULT - Call your prescriber’s clinic and tell them you have a positive test result for COVID-19. It is likely that your prescriber will allow you to have additional TADs to cover the period you need to isolate. Your doses can be collected by a 3rd party, (e.g. a person who is a friend/relative, case worker) The interim COVID-19 guidelines cover 3rd party pick-up, more information, (including specific consent forms) can be found here. *We strongly suggest you consider who this (‘3rd party) person might be NB: it must be a person who you trust to collect and transport your doses to you, has photo ID and the pharmacist and prescriber approve of. Contact your dosing pharmacy and inform them you have a positive test result for COVID-19. that you have spoken to your prescriber and who your nominated 3rd party is. If you are worried or feel you are not able to do this on your own, or if you have any questions, or concerns please call PAMS on 1800 443 844 so we can help guide you through it. More Tips for People on Pharmacotherapy During COVID-19 If you have not seen the first lot of tips, they can be found here. New Tips for People on Pharmacotherapy: Stay on your pharmacotherapy program: over the last couple of weeks, some people on methadone or buprenorphine-naloxone have reported to PAMS that they either missed doses or at worst stopped dosing altogether in an attempt to avoid COVID-19 or to keep family/friends safe. In all honesty, this is crazy, you need your dose, (usually daily). If opioid dependent and not on a program, consider starting treatment: over recent weeks, we have been hearing that supplies of illicit drugs such as heroin are dwindling, quality is decreasing, and prices are increasing. We have experienced an increased demand for the methadone/buprenorphine-naloxone program in recent weeks. In order to prevent the possibility of opioid withdrawal, we encourage you to consider starting/re-starting treatment for opioid dependence, (pharmacotherapy). Get Naloxone: as we all know, naloxone is used to reverse an opioid overdose, including a methadone overdose. With an increased amount of methadone TADs and a supply of heroin that is likely fluctuating, the more Naloxone in circulation the better we can respond to an opioid overdose. We strongly encourage you to ask your prescriber for a prescription of Naloxone. NB: All pharmacotherapy prescribers are being encouraged to provide each patient with a prescription of Naloxone. If you get more TADs, please look after them: it is very easy for us to forget that just one methadone dose can kill several non-opioid-tolerant individuals. One of the contra-indications to getting TADs is having no safe storage unit. If your TADs are stored safely, there is no chance that kids, teenagers, visitors, (even house breakers) will be able to get hold of them. A pin-code safe can be purchased relatively inexpensively, otherwise a lockable cabinet or drawer can be utilised. TADs of buprenorphine-naloxone, (Suboxone Film): people who are stable on Suboxone Film may find themselves with a 14-28-day supply of TADs during COVID-19. Please be very careful about ensuring you keep track of your TADs and do not miss the day you are due back at the pharmacy for your next in-store dose. Missing doses during COVID-19 can be risky as if you miss more than 4 in a row, you will have to be reviewed by your prescriber before you can resume dosing. Complications can occur if your prescriber is unavailable, (e.g. due to being unwell), reluctant to re-start people via tele-health (if this is all your prescriber offers) insisting you see a new prescriber (if you have no history with the new prescriber it might be difficult to get TADs). Tip,: set an alarm/reminder message on your phone so you do not miss a dose/s at the pharmacy. Photo ID: Having photo ID is always handy. For example, many prescribers require photo ID at the first appointment and pharmacists often ask for it along with a certified photograph, (colour photo of you signed by your prescriber). If you are required to self-isolate and need to arrange for a “3rd party” to collect your doses for a short period, the 3rd party will require photo ID. It is even possible you may become a nominated 3rd party if an acquaintance must isolate. Tip: If you do not have any photo ID, we strongly suggest you consider getting it. Update your contact details: It is easy to miss a call from your prescriber or pharmacist, especially if you do not have their contact details saved in your phone’s ‘contact list’. During COVID-19, it is essential you do not miss an important call such as this, (you might be called to change an appointment time, inform you about tele-health, let you know of a change to pharmacy dosing arrangements etc). Make sure your prescriber and pharmacy have your up to date contact details. We strongly suggest you give both prescriber and pharmacist a second contact person who knows how to find you, especially in case of emergency. If you do not yet have an email address, now is a good time to consider getting one – this will only work if you check your email regularly! If you can think of anything that we have not covered here or if there is anything you would like to ask us, or if you are experiencing a pharmacotherapy program-related problem you are unable to resolve on your own please do hesitate to contact PAMS on 1800 443 844. MORE COVID19 & PHARMACOTHERAPY INFO HERE

HRVic is a community based, not-for-profit organisation that represents people who use drugs. Community service awards include: COMING SOON Our new website is in progress. Please bare with us while we cross all our T's and dot all our i's.

NOW OPEN! The Victorian Pill Testing service at 95 Brunswick St, Fitzroy. - Opening hours, and all other features of the service, will be up for continuous review and improvement based on need and feedback (see below for ways to feed in). - You can come in and get any pills, powders, crystals, gels, or liquids tested on a range of fancy new technology (FTIR and GCMS instruments, as well as reagents and nitazine and fentanyl test strips). - In the coming weeks, our Paper-Spray Mass Spectrometer (PCMS) will be coming on line to assist further quantification and strength testing. This is the first of its kind in Australia! - You are covered from prosecution for possession of small amounts of drugs (personal use amounts) inside 95 Brunswick St, Fitzroy. This is the legislated "drug checking place". You aren't covered for trafficable quantities, and it's important to avoid bringing any large amount of drugs into the service. Please spread this important message far and wide throughout the community. We are still working on how best to give clear, simple key messages around this, without going into the weeds of grams and milligrams and different substances. Again, this is a key area for feedback and comms advice from our community! - Yarra Area Command of Victoria Police, have been instructed by the Chief Commissioner of Police to show "discretion in the vicinity" for possession of small amounts of illicit drugs for personal use, and not to discourage people accessing the drug checking place. Any issues with safely accessing the service should be communicated to service providers and to HRVic specifically. - Harm Reduction Victoria are employing harm reduction peer workers with living experience of drug use on every shift. 2 peer workers will be available each shift to provide you your drug checking results, who will be working alongside 2 Health and Harm reduction Workers with healthcare training, who are from our partners at The Loop Australia. We will also be employing an Operations Lead for the fixed-site, which is a designated peer leadership role within the service. - Harm Reduction Victoria will also be setting up a Service User Reference Group in September, to inform service improvement and service evaluation throughout the rest of the trial. Make sure you're signed up for updates at: www.hrvic.org.au/dcsignupdates - There are QR codes up at the service that link to an anonymous feedback and complaints form for all service users to access, as well. And we encourage any and all feedback, always! This is just the beginning of drug checking in Victoria, and we need your input. - We are also working on ways to further include more members of our community in the rest of the trial, and in Harm Reduction Victoria's work preparing for the end of the trial come August 2026. You can email: policy@hrvic.org.au to inquire further about this, ask questions, or share your feedback and ideas. And again, make sure you're signed up for updates at: hrvic.org.au/dcsignupdates Come and say hey any Thursday, Friday or Saturday arvo, and get your drugs checked Free, legal, and anonymous! And join in with this exciting new investment into harm reduction in Victoria 🙂

Mobile Service Info Past Events The 18 month implementation trial started with mobile drug checking sites at selected festivals and events across Victoria. Previous festivals include Beyond The Valley, Hardmission (Au), Pitch Music & Arts Festival, Ultra Australia and The Warehouse Project. The service will operate at five more music festivals in the 2025-26 summer festival season. Beyond The Valley 2024/25 Read the Report ULTRA Australia 2025 Read the Report Hard Mission Australia 2025 Read the Report The Warehouse Project Australia 2025 Read the Report Pitch Music & Arts Festival 2025 Read the Report COMING NEXT SEASON

HRVic's latest program brings people with lived experience and authentic, relevant, real-world, CURRENT experience with: substance use - various substances, injecting and otherwise experience with Hepatitis B - living with and treatment of experience with Hepatitis C- living with and treatment of experience with HIV - prevention and treatment experience with stigma & discrimination in healthcare settings, in the workplace etc. as a person who uses drugs in Victoria/Australia, and/ or as a person with a BBV HRVic's lived experience speakers are trained, remunerated and given ongoing support by HRVic and choose to speak candidly of our experiences publically at forums, conferences, panels and presentations. We at HRVic and we as peers and speakers feel that sharing real experience and putting real faces to real stories is the only way educate, enlighten and inform health workers and to challenge and combat stigma and discrimination against people who use drugs and people with BBVs. For More Information about booking a 'Speaking Peer- spectively ' lived experience speaker or to enquire about becoming a speaker on HRVic's 'Speaking Peer-spectively' team please email admin@hrvic.org.au or call 9329 1500.

DanceWize team members come from all over Victoria, from all walks of life, and all backgrounds with a love of and lived experience of the festival/doof/party and EDM communities the thread they all have in common. Invaluable knowledge, empathy, integrity, and motivation from their own experiences accompanies every DW key peer educator on each shift. All DW team members and team leads identify as peers to the communities of people who use drugs in the music scenes that they love and as such, allow for a greater understanding of their community members' experiences, equipping them with the skills and empathy needed to provide relevant, nonjudgmental support to festival patrons who use drugs. Volunteers are inducted and trained to fulfil the role of Key Peer Educator (KPE). DanceWize KPEs have several areas of responsibility at an event including roving, brief interventions and education, info sharing and care interventions. Volunteer intake and induction training happens during the winter season only. Once you have submitted a completed online form (button below), you will be added to our monthly DW Peer E-Newsletter, which includes all new information about training opportunities. You should start receiving this E-News straight away but you can always keep updated through our facebook page and groups. As DanceWize provides 1 on 1 care in Click on the link and fill out the form. NEW Vollys VOLUNTEER HERE Current KPEs What Does A DanceWIze Volunteer KPE Do? Care Interventions Care interventions mostly occur on site, at events within the DanceWize space; an airconditioned/heated, private, safe, chill space dedicated to providing support and 1:1 care to patrons experiencing distress or just needing a break. KPEs provide various types of care depending on the needs of each individual patron. The DW Chill space is always co-located with onsite medical services and we monitor our patrons carefully while awake or asleep to determine if they need further care or support. Roving Care Roving Care teams consist of a minimum of two KPEs walking throughout event grounds, campsites and party perimeters , keeping an eye out for people who may be feeling less than great or are confused. Our Rovers can provide support either directly through supplies they have on hand and support or if necesary can radio the DW Chill space, security or medical if needed. Our rovers have radio contact with all necessary service providers. Our DW Rovers are on the look out for signs of overdose or distress, and are often the first point of contact for a patron needing further intervention or assistance. GBV/ Trauma Counsellor The role of a GBV/Trauma Counsellor is specialised and requires volunteers to have appropriate post grad qualifications in Social Work, Counselling, Psychology, or for someone to have had extensive experience in the community services sector. Interviews will take place for these roles with the GBV Service Manager and a Team Coordinator Brief Interventions Brief interactions occur either onsite at an event or in transit to and from an event or in the DanceWize/HRVic office /NSP environment . KPEs and staff assist patrons and service providers alike to learn more about substance use, polydrug interactions, myth busting, drugs and the law, and referrals to services as required. Our KPEs are extensively trained to be able to answer questions that patrons might have regarding drugs, safer use, and other health and self care tips. We have extensive resources produced by HRVic and DW as well as other orgs available at every event, alongside consumables such as sunscreen, water and hydrating powders, lollypops, ear plugs, hand sanitiser, masks, condoms and NSP equipment. Gender Based Violence (GBV) and Mental Health services The GBV and Mental Health Service offers a comprehensive suite of services , and festivals can choose which activities they would like to engage with. The service is focused on interventions that target the whole festival community. For more info please click HERE. DW Team Lead Experienced KPEs can apply to become a Team Leader, and if successful receive extra training and support to fulfil higher duties of responsibility in leading teams of KPEs at events. Some Team Lead roles at specific events are casual paid roles. Apply to be a Trauma Counsellor or Roving Active Bystander

PAMS HISTORY The Long & Short of it...... The Short...... Since its beginnings in 2000, PAMS has evolved on a number of fronts. The service was originally established to help express consumer-related complaints and grievances, but has moved on to the negotiation and solving of these issues. This development was driven by service users, most of who are less interested in making a complaint than having their problem actually solved, usually within a short space of time. Other developments since the service first began include: the number of cases dealt with by PAMS has increased annually the name of the service has changed from MACS (Methadone Advocacy and Complaints Service) to PAMS the method of data collection and analysis has been computerised the service has become more widely known across the drug treatment sector the service has become increasingly professional. From small beginnings, PAMS has grown into a established service that plays a vital role within the Victorian opiate pharmacotherapy system. The Long..... The Pharmacotherapy, Advocacy, Mediation and Support’ (PAMS) Service was conceived by a small group of methadone consumers who used to meet regularly at the office of VIVAIDS (the Victorian Drug User Organisation) in the mid to late 1990s. A number of people in this group had experienced a range of problems with their methadone program they were not able to address effectively on their own. Further still, the group members felt there was no avenue through which they could get these issues addressed in a timely and effective manner. As a result, VIVAIDS undertook some qualitative, action based research to investigate the nature of these pharmacotherapy consumer concerns. This report ( ‘pale blue report’ by Kirsty and Nicola) is available upon request from pams@hrvic.org.au . In the year 2000, Turning Point Alcohol and Drug Centre was funded by the Commonwealth Government to run a number of trials of ‘new’ pharmacotherapies, including buprenorphine (mono formulation), slow release oral morphine and leva alpha acetyl methanol (LAAM). These trials were undertaken as part of the ‘National Evaluation of Pharmacotherapy for Opioid Dependence’ (NEPOD). Turning Point then agreed to fund VIVAIDS to pilot a telephone service for the pharmacotherapy consumer group to address the need for any of the following: Information and support Resolution of complaints and grievances Advocacy Mediation Referral Although the service was funded by Turning Point, it was available to any pharmacotherapy consumer in Victoria. The service focussed on the resolution of pharmacotherapy consumer related complaints and grievances and was called the ‘Methadone Advocacy and Complaints-resolution Service’ (MACS) and located at the VIVAIDS office in Carlton. MACS was promoted to the methadone consumer group at pharmacies, GP clinics, community health services, NSPs, welfare services, community legal centres and housing agencies. MACS initially operated from a mobile number, it was run by one staff member (who coordinated the service) and was available from 10AM to 6PM, Monday to Friday. A steering group was established to provide advice and strategic direction for MACS. Members of the steering group included: A GP (experienced pharmacotherapy prescriber), A pharmacist (experienced in the dispensing of methadone), A consumer representative (on a methadone program), The coordinator of MACS, A representative from Turning Point (clinical services), The manager of VIVAIDS Representatives from other relevant alcohol and drug services. In keeping with the other VIVAIDS programs and projects, MACS maintained a strong focus on peer support and representation. The methadone consumer group had access to a peer support worker (from MACS/VIVAIDS), GPs had access to another GP prescriber and pharmacists had access to a pharmacist (pharmacotherapy dispenser) through MACS. The GPs and pharmacists who provided support to their peers involved in a MACS case were available on an ‘on call’ basis. VIVAIDS chose to operate MACS in this way because peers have credibility amongst their peer group. It was also because MACS was new and unknown to GPs and pharmacists and the best way to promote it was again, through the respective professions (peer groups). In practice, this resulted in MACS operating in the following way: A methadone consumer contacted MACS because he felt that his GP (prescriber) did not understand his need for more than one methadone TAD per week. The consumer maintained that he had just been offered part-time work in a family company; nobody in his family knew he was on the program and he said he could not get to his pharmacy during working hours. The consumer said that if he disclosed to his family that he was on the program, any offer of work would be withdrawn. The MACS worker would discuss the issue with the consumer and try to work out a possible solution. The consumer said he would require a minimum of 3 TADs per week in order to work for his family. The MACS worker established that the current dosing point was the only pharmacy with a vacancy in the area. The MACS worker would ensure that permission was obtained from the consumer to contact their GP. The MACS worker would then contact the GP prescriber who provides peer support to other GPs involved in any MACS ‘case’ (MACS GP). This GP then contacts the consumer’s prescriber and discusses the issue. The MACS GP then calls the MACS worker and a course of action is agreed upon. For example, a compromise in this scenario might be that the consumer can have a total for 3 TADs per week, but not for 3 days in a row. The MACS worker then puts to possible solution to the consumer and the MACS GP suggests the same solution to the consumer’s GP prescriber. If all parties agree, no further negotiation is required, if not then both the MACS worker and the MACS GP may go through the same process again until an agreement has been negotiated on behalf of the consumer and his service provider. Theoretically, this was an equitable, unique and supportive way to operate the service. However, due to the need to depend on the availability of the MACS GP (also a current prescriber with his/her own case load) and the MACS Pharmacist (also running his/her own pharmacy) and to resolve the cases quickly, (often so a consumer could dose within 24 hours), it simply became impractical. As the number of cases dealt with by the service rapidly increased, there was simply not enough time to utilise the services of the MACS GP and Pharmacist. Over time MACS gradually became known to GPs, Pharmacists and the methadone consumer group. After running the pilot for 12 months, (funded by Turning Point), VIVAIDS had collected enough data to indicate that MACS was a useful and effective service. VIVAIDS took the data to the Victorian Department of Health, (Drugs Policy and Services) and they agreed to fund the service. The Victorian Department of Health (DoH) have continued to fund the service to this day. After buprenorphine was approved by the TGA and registered on the PBS, meaning it became available as a treatment for opioid dependence in Victoria, MACS changed its name to the ‘Pharmacotherapy Advocacy and Complaints-resolution Service’ (PACS). However, PACS had a problem in as the name included the word ‘complaint’. Unfortunately, this resulted in GPs and Pharmacists feeling that “somebody had complained” (about them). This left providers feeling ‘on the back foot’ and defensive before any conversation had taken place. PACS was also compromised by the fact that it had no powers of enforcement to effectively deal with consumer complaints and grievances. If a pharmacotherapy provider did not want to negotiate with the PACS worker, there was often very little the service could do resulting in consumers feeling frustrated, powerless and that they had wasted their time. Interestingly enough, the majority of consumers in direct contact with PACS did not want to make complaints as such, they had problems they wanted resolved effectively and efficiently. These issues culminated in the name and the focus of the service changing. PACS changed its name to the ‘Pharmacotherapy Advocacy, Mediation and Support’ (PAMS) Service. This new name accurately reflects the role of the PAMS Service. PAMS SYSTEMIC ADVOCACY & REPRESENTATION ADVOCACY The PAMS service primarily works on resolving individual pharmacotherapy consumer-related problems and concerns. Through its work, the service develops a unique perspective into and an understanding of the Victorian Pharmacotherapy Service System. This specific knowledge and insight is often requested by policymakers, researchers and professional groups. For example PAMS has been involved in the following: Research Sub-Optimal Dosing of Methadone in Victoria Role of Methadone Take Away Doses in NSW and Victoria Post-Surveillance Marketing of Buprenorphine-Naloxone (Suboxone) Pharmacotherapy Funding Models Study Reviews Review of the Pharmacotherapy Rural Outreach Workers (PROW) Review of the Victorian Pharmacotherapy Program (2010) Review of the Specialist Pharmacotherapy Service (2013) Committees Harm Minimisation Committee (Pharmaceutical Society of Australia, Victorian Branch) Victorian Department of Health – Pharmacotherapy Reform Advisory Committee Inner East Medicare Local Pharmacotherapy Committee Policy Development Pharmacotherapy Policy for Maintenance Pharmacotherapy for Opioid Dependence (2008) – Victorian Pharmacotherapy Guidelines Pharmacotherapy Policy for Maintenance Pharmacotherapy for Opioid Dependence (2013) – Victorian Pharmacotherapy Guidelines Buprenorphine-Naloxone Prescribing for Non-Registered GPs (2013)

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.

Inner City The Inner City covers North Melbourne, Carlton, Collingwood, Richmond, East Melbourne, West Melbourne and South Melbourne. This list consists of the clinic names and their locations. If you click on their address you will open the google maps page for that location. To book at any of these locations, you will still need to call 1800 675 398 or through the online booking system (you need an email address to sign up) CoHealth Melbourne Town Hall 90-130 Swanston St, Melbourne Open Monday to Friday, 10:15am to 4:30pm. Walk-ins are available for: people experiencing homelessness people with English literacy limitations refugees international students If you don’t have a Medicare card or ID, you can still get the vaccine. North Richmond Community Health (NRCH) Community Room North Richmond Community Health 23 Lennox St, North Richmond 3121 Please click here to book an appointment online or call 9418 9800. C ohealth Centre West Melbourne 98 Abbotsford Street, West Melbourne Medical Hub @ RMIT RMIT University, Building 8, Level 3 368-374 Swanston St, Melbourne You must have a current Medicare Card to receive a COVID-19 vaccination here. C ohealth centre Collingwood 365 Hoddle Street, Collingwood Livingroom: COVID19 Vaccine MIHS VAN Phone: 9662 4488 for appointment Max 20 registrations in a day (Some capacity for drop-in on the day if some registrations do not arrive) FIND A PHARMACY INNER CITY

Button Around 170,000 Australians are living with chronic hepatitis C infection. Many Australians do not know they are infected, or that they could be cured. These people are at risk of developing liver damage, cirrhosis, and liver cancer. Some people will require liver transplants, and many will not survive. They are also at risk of transmitting the virus onto others. The consequences of hepatitis C in Australia are far-reaching, but they don't need to be. Hepatitis C is treatable and curable. It's therefore essential that we test and treat as many at-risk people as we can. It's simple and cheap to be tested, and curative treatments are now listed on Australia's Pharmaceutical Benefits Scheme (PBS). HRVic is committed to working with the rest of Australia towards the World Health Organisation's goal of eliminating hepatitis C by 2030. HRVic have joined forces with the Burnet Institute and EC Australia. We have developed an approach that involves peer specialists working at strategic clinical services to assist our community to navigate and overcome the barriers to treatment and to access services. Introducing the PATH program- Peer Assisted Treatment for Hepatitis. and now the PATH-Ex program- an extension of the PATH program. The aim of PATH-Ex is to ensure that People Who Use Drugs are empowered, informed and supplied with the tools needed to access information, testing and treatment for hep C. We seek to take advantage of the unique empathy and support that comes only from the peer-to-peer relationship to encourage engagement with health services and ongoing support to jump through the hoops that life can put in our way when undertaking any longer term treatment course. You can read more about these principles here . Our PATH workers are outposted in St Kilda, the city and Footscray and the west. During COVID lockdown they are only able to undertake outreach, but as the lockdown end we are hoping to be back to more hours at Access Health, Living Room and cohealth West.

West and South West The West & South West areas covers Williamstown to Wyndham Vale and Eynesbury to Caroline Springs back to Footscray. This list consists of the clinic names and their locations. If you click on their address you will open the google maps page for that location. To book at any of these locations, you will still need to call 1800 675 398 or through the online booking system (you need an email address to sign up) unless it states otherwise. Melbourne Showgrounds 04 Boulevard Pavilion Opening Hours: 8:00am – 5:30pm seven days a week due to high demands. Sunshine Hospital Sunshine Hospital Vaccination Hub St Albans, Vic. Capacity : up to 60 cubicles Purpose-built semi-permanent facility constructed in the ground floor of the site’s multi-deck car park. VU Whitten Oval (pop-up vaccination hub) The VU Whitten Oval COVID-19 Vaccination Hub only runs on certain days. Check the website for details and dates of operation. This site will be offering Pfizer only. Caroline Springs Leisure Centre Located at 9-19 The Parade Caroline Springs Bookings accepted, check the online booking system or call 1800 675 398 for availability. Walk ins are accepted at this vaccination centre for Pfizer and AstraZeneca. The Melton Vaccination Hub Located at 149 Barries Rd Melton West. This Hub has two vaccination services – a drive through service and a sit down vaccination centre. The drive through service is the first of its kind in Australia. Click here or on the following image to view a short video about this service. Chemist Warehouse Braybrook Home Co Tenancy 3A & 3B 340-342 Ballarat Road Burke & Butler Streets BRAYBROOK Phone: +61385271774 Bookings must be made online. Book HERE. IPC Health Vaccination Hub Caroline Springs Leisure Centre 9-19 The Parade, Caroline Springs Open Monday to Friday 10am-6pm and Saturdays 9am-6pm. Open public holidays Cohealth Centre Laverton 95-105 Railway Avenue, Laverton Open Monday to Friday, 9:30am to 4:30pm Call 9448 5552 Werribee St Vincent’s Private Hospital The Werribee COVID-19 Vaccination Hub is located at St Vincent’s Private Hospital, 240 Hoppers Lane, Werribee. The entrance and parking is available at the rear of the hospital. Wyndham Eagle Stadium Located at 35 Ballan Road, Werribee. This Hub has two vaccination services – a drive thru service and a sit down vaccination centre. Priceline Pharmacy Sunshine Marketplace Shop 45, Sunshine Marketplace S/C 80 Harvester Road SUNSHINE Open 09:00 to 17:30 +61393647133 Bookings must be made online. Book HERE. FIND A PHARMACY WEST & SOUTH WEST

5toLife- Respond to Opioid Overdose with naloxone. PAGE UNDER CONSTRUCTION 5 T o Life Steps continued from HRVic opioid reversal kit instruction sheet REVERSE OPIOID OVERDOSE How To Videos: Ampoules- Injectable Nyxoid- Nasal Spray Prenoxad- Injectable 5 to Life: Naloxone Instructions AMPOULES-Naloxone Instructions FAQs Frequently Asked Questions ABOUT NALOXONE THE PRODUCT: What is naloxone? Naloxone is a TGA approved medicine thats ONLY use is to quickly (but temporarily) reverse an opioid overdose. What else is naloxone used for? Naloxone, also known as it's brand names Narcan, Nyxoid or Prenoxad, can be administered as a nasal spray or by injection. It quickly but temporarily reverses an OPIOID overdose only. Examples of opioids are heroin, fentanyl, oxycodone, hydrocodone, codeine, and morphine and nitazenes. It will not work on ove rdoses from cocaine, methamphetamine, or other non-opioid drugs. page under construction......