In April of 2008 the staff of Kullaroo Clinic on the Central Coast of NSW established a buprenorphine/naloxone clinic. This clinic was initially set up due to concerns at the high cost to patients of receiving their buprenorphine/naloxone from community pharmacies. It soon became apparent that additional significant advantages accrued to both patients and the service. These advantages included: 1) better monitoring of patients, 2) improved patient compliance, 3) improved staff morale, 4) reduction in time spent dosing patients, 5) improved retention in treatment, as well as, 6) a significant reduction in cost to the patient.

To date there are around 15 patients enrolled in this clinic and it is anticipated that this number will grow over time. Our sister clinic – Wallama- is exploring the possibility of setting up a similar clinic learning from the experience at our clinic.

This presentation will explore the rationale for setting up this service. Areas to be discussed will include: 1) the regulatory framework, 2) selection of patients, including process of induction, 3) cost savings to service, 4) cost savings to patients, 5) process of progressing to greater intervals between presentations, 6) dealing with special cases such as elective surgery and pregnancy, and, 6) a preliminary analysis of data from the clinic.

We believe that similar dedicated buprenorphine/naloxone clinics could be set up elsewhere with similar advantages.