Placements and Accreditation

Whilst both allow you to prescribe opioid pharmacotherapies for patients, there are some differences:

• Recieving an authority to prescribe under supervision as a registrar means that you have been granted permission to prescribe in a limited capacity if you are a new registrar based at a public alcohol and drug clinic. You will be limited to prescribing only to a maximum of 125 patients and will not be able to prescribe in the same capacity outside of your workplace. A registrar applies for authority to prescribe under supervision at the commencement of their registrar rotation, and is only valid for that duration. For more information this application visit the page for AOD registrars seeking authoirty under supervision. Registrars are also strongly encourage to proceed with applying for full accreditation during their registrar rotation (see below for more information).
• Recieving accreditation to prescribe opioid pharmacotherapies allows for medical practitioners (regardless of registrar status) to prescribe for up to 200-300 patients within any workplace setting, including private practice. Accreditaiton also removes some restrictions that would otherwise be in place if you prescribe unaccredited. For nurse pracitioners, accreditation allows you to prescribe opioid pharmacotherapies within the scope of your practice.To apply for accreditation, you must 1) complete the Opioid Treatment Accreditation Course (OTAC), 2) undertake a clinical placement, and 3) submit your application for accreditation. Refer to the following pages on accreditation for medical practitioners and nurse pracitioners for more information.

As a general rule, the following health professionals are deemed appropriate supervisors:

• Addiction medicine specialist (that is, a medical practitioner who is a member of the RACP Chapter of Addiction Medicine)
• Addiction psychiatry specialist (that is, a medical practitioner who is a member of RANZCP Faculty of Addiction Psychiatry)
• Another experienced prescriber of opioid agonist treatment (e.g., general practitioner specialist) may be appropriate as a supervisor. We recommend you contact us to confirm if they are appropriate before undertaking a placement.
• An experienced nurse practitioner in a drug and alcohol setting who prescribes opioid agonist treatment may be appropriate as a supervisor. We recommend you contact us to confirm if they are appropriate before undertaking a placement.
• In regional and remote areas, other options for clinical placements can be considered, and we encourage you to contact us to discuss these options.

Your AHPRA number is required when completing an application for accreditation to prescribe opioid pharmacotherapies or for registrars seeking authority to prescribe opioid pharmacotherapies under supervision at their workplace.

You can search for your AHPRA number through their website here.

You can contact us if you have submitted an application already and your details have changes, or you believe you have made a mistake.

Registrars under supervision at a public alcohol and drug treatment clinic are still encouraged to still complete the Opioid Treatment Accreditation Course (OTAC), undertake a clinical placement and apply for full accreditation. Registrars will initially apply for authority to prescribe under supervision whilst at their workplace, however this is a limited authority and doesn’t extend beyond your workplace role.

Receiving accreditation allows you to prescribe in other settings outside of your registrar capacity and with a higher patient load. Further information on the accreditation process for medical practitioners can be found here.

Further details on the OTAC can be found here.

If you are an interestate prescriber seeking accreditation in NSW it may be possible for your accreditation to be recognised in NSW.

Similarly, if your accreditation has lapsed in NSW (i.e., typically, if you have not prescribed opioid pharmacotherapies for a patient at least once in a two-year period), you can apply for your accreditation to be re-instated.

For information about your particular situation, contact us.

If you a registrar under supervision applying for authority under supervision: The application process can take up to 3 working days. If you have not received approval of authority to prescribe under supervision you can contact the OTP line on (02) 9424 5921 or can email the OPS Secretariat at: MOH-OTP-Accred@health.nsw.gov.au.

If you are a medical practitioner or nurse practitioner seeking accreditation: Once you have submitted your accreditation application, the NSW Ministry of Health Opioid Pharmacotherapy Subcommittee (OPS) will consider your application at a session approximately once every 6 weeks. To ensure your application is considered at the OPS  meeting, you must submit your application at least 10 days prior to the following committee dates:

OPS Committee Dates for 2023

• • Thursday, 16^th February
  • Thursday, 30^th March
  • Thursday, 11^th May
  • Thursday, 29^th June
  • Thursday, 3^rd August
  • Thursday, 21^st September
  • Thursday, 26^th October
  • Thursday, 14^th December

If your application is urgent and you believe needs to be considered out of session, contact us.

This depends on several factors, which are briefly outlined below:

If you are a registrar under supervision: You can prescribe for up to 125 patients at the nominated workplace(s) on your application within the Local Health District or Specialty Network that you are based in. The authority to prescribe does not extend beyond your nominated workplace.

If you are an accredited medical practitioner or nurse practitioner: If accredited, you can prescribe in 200 patients in private or 300 patients in public settings. In certain circumstances, you can apply for this allocation can be increased by contacting the Opioid Pharmacotherapy Subcommittee (OPS) Secretariat: moh-otp-accred@health.nsw.gov.au

Unaccredited medical practitioners: If you do not fulfil either of the above criteria, you are deemed an unaccredited medical practitioner (nurse practitioners are unable to prescribe opioid treatment unless accredited). You can still prescribe opioid pharmacotherapies to patients in a limited capacity, as follows:

• Methadone: Up to ten (10) low-risk patients on methadone who are being transferred from an accredited prescriber, and should engage with the previous accredited prescriber.
• Buprenorphine: Up to twenty (20) patients on buprenorphine pharmacotherapies, including buprenorphine (mono), buprenorphine-naloxone and depot buprenorphine preparations.

To clarify, the total number of patients that an unaccredited prescriber may obtain authority to prescribe for, at any one time, is thirty (30) with a maximum of 10 of these patients being for methadone.