Patients on the NSW Opioid Treatment Program (OTP) may be transferred from methadone to buprenorphine. There are three ways for health professionals to enable this transfer:
- Direct transfer (conventional method)
- Buprenorphine micro-dosing
- Bridging with a short-acting opioid
When using direct transfer, prescribers should refer to:
Micro-dosing and bridging
When using the micro-dosing or bridging methods, prescribers should refer to the
NSW Interim Clinical Guidance – Outpatient Transfer from Methadone to Buprenorphine Using the Micro-dosing or Bridging Methods.
The evidence base for the micro-dosing and bridging methods is still developing. Use of opioid agonist treatment medications in this context is considered off-label and must be undertaken in accordance with:
- local clinical governance procedures
- legislation, policies or procedures that govern off-label prescribing
The following prescribers are eligible to undertake micro-dosing and bridging:
- Addiction Medicine Specialists and Addiction Psychiatrists
- Other medical practitioners who are OTP accredited
- Nurse practitioners who are OTP accredited and work in public or Justice Health & Forensic Mental Health Network settings
