Welcome to In Hindsight, a podcast series designed for general practitioners, medical professionals, and other health providers involved in or interested in providing opioid agonist treatment (OAT) for opioid dependence, including methadone and buprenorphine.
Each episode delivers concise, insightful discussions on the challenges and nuances of managing patients with opioid dependence. We feature discussions with General Practitioners, Addiction Medicine Specialists, Pharmacists, and Nurse Practitioners at the forefront of the AOD (alcohol and other drugs) space.
At each episode, our guest speakers provide up-to-date information on various aspects of OAT, sharing valuable lessons learned ‘In Hindsight’ from their professional experiences. These insights offer actionable takeaways to enhance your approach to patient care.
Meet the Host!
Dr Marianne Jauncey is a Public Health Physician and the Medical Director of the Uniting Medically Supervised Injecting Centre (MSIC), a role she has held since 2008. She is a leading voice in harm reduction, a passionate advocate, media spokesperson, and community educator who isn’t afraid to speak up and get people talking.
Podcast Episodes
Fundamentals Part 1
- Title: Fundamentals Part 1
- Speakers & Affiliations: Prof Paul Haber (Clinical Director, Drug Health Services, Sydney LHD), Dr Sally Fotheringham (Advanced Trainee, Sydney LHD)
- Recording Date: August 2024
- Summary: In Fundamentals Part 1, listeners will learn the fundamentals of the Opioid Treatment Program (OTP) in NSW, including the diagnostic criteria for Opioid Use Disorder (OUD) and the associated health, social, and legal risks. The episode covers the assessment and treatment planning for patients with OUD, highlighting effective treatment options such as Methadone and Buprenorphine. It also addresses the importance of considering patient preferences, conducting risk assessments, and monitoring treatment effectiveness. Additionally, listeners will gain an understanding of the administrative responsibilities involved in prescribing or discontinuing Methadone or Buprenorphine.
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Fundamentals Part 2
- Title: Fundamentals Part 2
- Speakers & Affiliations: Prof Paul Haber (Clinical Director, Drug Health Services, Sydney LHD), Dr Sally Fotheringham (Advanced Trainee, Sydney LHD)
- Recording Date: August 2024
- Summary: In Fundamentals Part 2, listeners will expand their knowledge of the Opioid Treatment Program (OTP) in NSW by exploring the assessment and management of common challenges during the treatment of Opioid Use Disorder (OUD). Topics covered include evaluating drug interactions, determining patient risk levels, and monitoring for domestic violence. The episode also discusses the management of take-away doses, educating patients on safe medication storage, transitioning from Methadone to Buprenorphine, and addressing treatment-related side effects. Additionally, listeners will gain insights on managing patient ambivalence, driving while on treatment, and handling requests for take-away doses.
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Managing Acute Pain in Patients on OAT
- Title: Managing Acute Pain in Patients on OAT
- Speakers & Affiliations: Dr Joshua Watt (Addiction Medicine Specialist, Sydney LHD), Maureen Steele (peer worker)
- Recording Date: June 2024
- Summary: This podcast covers managing acute pain in patients on Opioid Agonist Treatment (OAT), including Methadone and Buprenorphine. It reviews pharmacological and non-pharmacological approaches, with key differences between hospital and outpatient settings. The importance of assessing opioid tolerance, overdose risk, and specific considerations for Long-Acting Injectable Buprenorphine (LAIB) are highlighted. Risks of inappropriate prescribing and strategies for safer, more effective pain management are discussed. A guest with lived experience shares their perspective on inadequate acute pain treatment while on OAT.
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Managing Chronic Pain in Patients on OAT
- Title: Managing Chronic Pain in Patients on OAT
- Speakers & Affiliations: Prof Apo Demirkol (Director, Drug and Alcohol Services, South Eastern Sydney LHD)
- Recording Date: June 2024
- Summary: This episode focuses on managing chronic pain in patients on Opioid Agonist Treatment (OAT). It explains why chronic pain is more common in this group and stresses accurate diagnosis to distinguish it from acute pain. Treatment approaches include therapeutic options, medication adjustments such as split dosing, and setting functional goals. The podcast highlights use of tools like the Brief Pain Inventory (BPI), patient safety strategies, and the role of effective provider–patient communication in pain management.
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Prescribing OAT in Rural and Regional Areas of NSW
- Title: Prescribing OAT in Rural and Regional Areas of NSW
- Speakers & Affiliations: Dr Bronwyn Hudson (Addiction Specialist, Northern NSW LHD) and Dr Patricia Collie (Clinical Director, Northern NSW LHD)
- Recording Date: July 2024
- Summary: This podcast explores the aspects of prescribing OAT in rural and regional areas of NSW. It highlights the importance of collaboration with other professionals, tackles challenges like stigma and anonymity, and discusses effective risk management strategies. The episode includes case management stories and experiences from prescribers during floods.
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Long-Acting Injectable Buprenorphine
- Title: Long-Acting Injectable Buprenorphine
- Speakers & Affiliations: Prof Nicholas Lintzeris (Director Drug & Alcohol Services, South Eastern Sydney LHD) & Dr Thomas Lu (GP & Addiction Medicine Advanced Trainee, South Eastern Sydney LHD)
- Recording Date: July 2024
- Summary: This episode provides information on Long-Acting Injectable Buprenorphine (LAIB) products, covering dosing, advantages, disadvantages, and the risk of precipitated withdrawal. It also discusses updates to NSW LAIB guidelines, the process of transferring from Methadone to LAIB, and challenges of prescribing LAIB in different clinical settings.
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Medicinal Cannabis and OAT
- Title: Medicinal Cannabis and OAT
- Speakers & Affiliations: Prof Nicholas Lintzeris (Director Drug & Alcohol Services, South Eastern Sydney LHD)
- Recording Date: September 2024
- Summary: This podcast covers the different types of medicinal cannabis products and the regulations for prescribing them in NSW. It considers the use of medicinal cannabis in specific groups, including people with chronic pain and those on OAT, and provides an overview of potential harms, benefits, and prescribing approaches.
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Providing Harm Reduction Services to People Receiving OAT
- Title: Providing Harm Reduction Services to People Receiving OAT
- Speakers & Affiliations: Dr Merissa Cappetta (Staff Specialist Addiction Medicine, South Eastern Sydney LHD), Candice Guilford (Peer Worker)
- Recording Date: May 2024
- Summary: This episode discusses harm reduction approaches for patients who use substances, particularly those on OAT. It features insights from an addiction medicine specialist and a peer worker, covering key strategies like take-home naloxone and nicotine replacement therapy. The podcast also addresses healthcare access barriers due to stigma and provides advice for new OAT prescribers.
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Opioid Agonist Treatment in Primary Care Setting
- Title: OAT in the Primary Care Setting
- Speakers & Affiliations: Dr Hester Wilson (Chief Addiction Medicine Specialist for NSW, Clinical Director for Murrumbidgee LHD Drug and Alcohol, Medical Advisor for Population and Community Heath in SESLHD)
- Recording Date: April 2026
- Summary: This podcast explores the role of GPs in opioid dependence treatment in primary care, focusing on safe prescribing of methadone and buprenorphine with support. It outlines practical steps for initiating treatment, managing stable patients, and addressing concerns such as prescribing confidence and coordination with specialist services. It also reassures GPs that care is structured, supported, and rewarding, improving patient outcomes.
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