An evaluation of opioid replacement pharmacotherapy in an urban Aboriginal Health Service

Abstract

Objective: This study aimed to evaluate the opioid replacement pharmacotherapy at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) in the Australian Capital Territory. Methods: Existing and new adult patients at Winnunga who were receiving opioid replacement pharmacotherapy were recruited. Twenty‐one of 30 eligible patients participated in this cohort study. The Brief Treatment Outcome Measure was administered to patients twice with an interval of at least three months. Primary outcome measures were retention rate in the program and self‐reported heroin use. Results: Eighty‐one per cent (17/21) of patients remained in treatment at three months. Median self‐reported heroin use for existing patients was 0 days/month at initial interview and follow‐up (95% CI 0–1). There was no significant difference between self‐reported heroin use at initial and follow‐up interview (paired Wilcoxon test, R=10, alpha=0.05). Mean self‐reported heroin use was 1.5 days/month at initial interview and 2.4 days/month at follow‐up. Conclusion: The retention rate of 81% and low levels of heroin use suggest that opioid replacement pharmacotherapy at Winnunga is comparable to the outcomes of mainstream treatment programs. Implications: Opioid replacement pharmacotherapy is beneficial to opioid‐dependent Aboriginal people in urban settings. Access to this treatment in culturally appropriate settings needs to be expanded.

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“…Since these earlier studies, culturally-centered MAT services have been successfully implemented with Indigenous people in Australia and Canada (19–21). In Australia, success was attributed to the culturally-specific design, integrated care, and a focus on family and community wellness (21).…”

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