• The number of deaths in Australia from heroin overdoses rocketed from 70 in 1979 to 550 in 1995. If this number of deaths was caused by any other factor there would be a national outcry.
• The costs of illicit drug use in Australia are estimated to be $1.7 billion, mainly law enforcement and health costs.
• HIV/AIDS and hepatitis B and C are transmitted by needle sharing. It is estimated that 50-70% of injecting drug users have hepatitis C.
• The suffering experienced by individuals, their families and the community from heroin- caused mortality and morbidity and drug-related crime.

Methadone is a long acting (more than 24 hours) drug from the opioid class (which includes morphine, pethideine, and codeine, etc.). The pharmacological effects of methadone helps prevent withdrawal, reduces drug hunger and in adequate amounts, blocks the euphoric effects of heroin and other opioids. It is taken orally on a daily basis.

MMT was introduced in Australia in 1970 at Wisteria House in Sydney. The first rural methadone programme was established in the Far North Coast by a psychiatrist in 1975. There are currently over 10,000 people on methadone in NSW and about 300 in the Northern Rivers area (Tweed to Grafton).

1. public clinics,
2. private clinics,
3. retail pharmacists, and
4. combination private and public sector programmes.

The Commonwealth Department of Human Services and Health has recommended the increased involvement of GPs and retail pharmacists. In a rural area, it is essential to have both groups involved in methadone in order to provide better access and equity to people with heroin problems in the towns, villages and more remote parts of the area.

A group of GPs in Byron Bay held a meeting in June this year to consider methadone prescribing. Their comments about being involved in MMT would be applicable to many other GPs. They viewed MMT as a beneficial response to treat heroin addiction. They thought the best model was a large number of GPs with a small number of patients, rather than a small number of GPs with a large number of patients.

The Byron GPs made representations to the NRHS to support the Methadone Prescribers Accreditation Course being conducted in this area and to provide support to GPs who may become involved in methadone.

Dr Tony Sherbon, CEO, said the NRHS would cover the costs of a Methadone Prescribers Accreditation Course (MPAC) and would offer the support of the Cedar Court methadone service. Acknowledging the large drug problem in the area, he said the NRHS needed to work with the three divisions of general practice in the NRHS to effectively respond to the consequences of heroin use.

MPAC includes a one day training course for medical practitioners who wish to prescribe methadone. CME points are allocated to the course.