Contemporary Approaches to Opioid Dependence Treatment Delivery: A Rapid Review of Novel Models Relevant to Implementation in Victoria, Australia

IF 2.9 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review Pub Date : 2026-08-18 DOI:10.1111/dar.70213

Shalini Arunogiri, Ali Cheetham, Michael Savic, Dan I. Lubman, Victoria Manning

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引用次数: 0

Abstract

Issues

Rising opioid-related harms and persistent barriers to opioid dependence treatment (ODT) access present critical challenges across Australia and internationally. Pharmacotherapy remains the most effective treatment for opioid use disorder, yet systemic gaps in workforce availability and service models limit reach and sustainability. Using Victoria as a case example, this review examines models with broad relevance to other Australian jurisdictions.

Approach

We conducted a rapid review of academic (PubMed, Ovid MEDLINE, ProQuest, Google Scholar) and grey literature published from January 2019–31 August 2025. Eligible studies described innovative ODT models including organisational redesign, expanded workforce roles and technology-enabled approaches.

Key Findings

Fifty-six publications were clustered into organisational (e.g., mobile outreach, emergency department initiation, low threshold rapid access clinics), workforce (nurse practitioner prescribing, pharmacist–prescriber collaboration) and telehealth-enabled models. Studies primarily measured critical short-term outcomes such as retention (up to 12 months), with limited longitudinal outcome data available.

Implications

Workforce development is critical, particularly through nurse practitioner expansion and pharmacist collaborative care, supported by sustainable funding and training pipelines. Telehealth and hybrid models can enhance accessibility while leveraging existing community infrastructure. Future research should prioritise patient-reported outcomes, cost-effectiveness and longer-term evaluations of novel care models.

Conclusion

This rapid review highlights innovative ODT approaches with potential to address access and workforce challenges. Staged implementation, supported by investment in infrastructure and evaluation, represents a timely opportunity for reform with relevance across Australia.

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阿片类药物依赖治疗的当代方法：与澳大利亚维多利亚州实施相关的新模型的快速回顾

阿片类药物相关危害的增加和阿片类药物依赖治疗（ODT）获得的持续障碍是澳大利亚和国际上面临的严峻挑战。药物治疗仍然是治疗阿片类药物使用障碍最有效的方法，但劳动力供应和服务模式方面的系统性差距限制了药物治疗的可及性和可持续性。以维多利亚州为例，本综述考察了与澳大利亚其他司法管辖区广泛相关的模型。方法：我们对2019年1月至2025年8月31日发表的学术文献（PubMed、Ovid MEDLINE、ProQuest、谷歌Scholar）和灰色文献进行了快速回顾。合格的研究描述了创新的ODT模型，包括组织重新设计、扩大劳动力角色和技术支持方法。56份出版物被归类为组织（例如，移动外展、急诊部门启动、低门槛快速访问诊所）、劳动力（执业护士开处方、药剂师-开处方者协作）和远程医疗支持模型。研究主要测量关键的短期结果，如保留率（长达12个月），有限的纵向结果数据可用。劳动力发展至关重要，特别是通过扩大护士执业人数和药剂师协作护理，并得到可持续资金和培训渠道的支持。远程保健和混合模式可以提高可及性，同时利用现有的社区基础设施。未来的研究应优先考虑患者报告的结果、成本效益和对新型护理模式的长期评估。这篇快速综述强调了创新的ODT方法，这些方法具有解决获取和劳动力挑战的潜力。在基础设施投资和评估的支持下，分阶段实施，为澳大利亚各地的改革提供了及时的机会。

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来源期刊

Drug and alcohol review SUBSTANCE ABUSE-

CiteScore

4.80

自引率

10.50%

发文量

151

期刊介绍： Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.