Solidarity and pharmacotherapy: What can we learn from opioid policy?

The prohibition and specific regulatory practices applied to psychoactive substances by politicians and bureaucrats over time are complex. Voices of those most affected by their decisions have mostly been systematically silenced or ignored. In few other spaces are these themes as present, sharp or high-stakes than in the area of opioid dependence. While traditional psychedelic drugs are undergoing a renaissance, other plant-based medicines, opium, heroin and their many derivatives, have occupied significant and ongoing institutional attention over the past two centuries; arguably continuing to this day.

This workshop explores key learnings from a collaborative project between Harm Reduction Victoria & the Department of Health conducted between 2023 and 2025. Starting with an account of the history of the prohibition, selective proliferation, and uses of opioids; this event will then introduce the work of HRVic's PAMS program (Pharmacotherapy Advice, Mediation & Support Service), as well as a policymaking project elevating the voices of those with "lived and living experience" of opioid dependence in the system planning and policy reform work of the Victorian Government in the Alcohol & Other Drugs portfolio. The presentation will describe key system features for the statewide prescribing and administration of Schedule 8 medicines via multidisciplinary care teams in community health and primary care settings, before introducing key political considerations involved in navigating marginalised communities, busy bureaucracies and powerful stakeholders to identify common interests and achieve positive public health and wellbeing outcomes. Learnings from this project may help to inform how to consider future policymaking around the development of therapeutic settings for psychedelic-assisted therapies - and perhaps especially those that are grounded in historical awareness, human rights and social justice.

The workshop will be broken up into the following three sections, each followed by an activity and Q&A. Under each section heading is a proposed learning objective for the workshop:

1 - History, culture, uses and discriminations around opioids

Recall global and local historical factors that drive the prohibition and continued use of opioid drugs.

2 - HRVic's PAMS program and hotline; & Victoria's crisis around opioid pharmacotherapy prescribers.

Engage with the current status of opioid dependence treatment in Victoria, and the different kinds of expertise keeping a complex and strained system together

3 - System planning and social change: working with governments & communities to redesign a state-wide service system

Engage with key factors and components of the ODT system, and the specific review process led by HRVic as service consumers.

Reflect on key themes, similarities and differences across different drug policy and therapeutic modalities.