Opioid prescribing resources
The Australian references for opioid prescribing — not a calculator (the FPM ANZCA one is the recognised national standard) but a curated index of the resources GPs actually need at the point of care.
Equianalgesic dose calculation: Use the
oMEDD calculator → on this site (browser-based, no login, conversion factors from FPM ANZCA PS01(PM) Appendix 2 Oct 2025) or the official
FPM ANZCA mobile app — same source data.
Equianalgesic tables are not switching protocols; specialist input recommended for any complex switch.
Reference index only — not prescribing advice. Opioid prescribing decisions remain the prescriber’s clinical responsibility, made against the current TGA Product Information, RTPM data for the individual patient, and your state’s S8 regulations. Verified June 2026. Confirm current criteria at the linked sources before prescribing.
🌿 Not prescribing medicinal cannabis? Referral pathways for CNCP:
When opioid-sparing alternatives are being considered for chronic non-cancer pain, medicinal cannabis is one option some patients ask about. If it’s not part of your practice, you can refer to a dedicated medicinal cannabis clinic (many operate Australia-wide via telehealth) or to another GP / specialist in the region who prescribes regularly. Any registered medical practitioner in Australia can apply to prescribe under the TGA SAS-B or AP scheme — no specialty required — but many GPs choose to refer rather than take on the per-patient TGA application and state S8 approval workload.
What to include in the referral: current medications, past treatments trialled (especially non-pharmacological), pain diary if kept, and any RTPM check results already on file. This makes the receiving clinician’s TGA application significantly faster.
Patient-facing overview:
Medicinal Cannabis in Australia — patient guide → · TGA source:
Medicinal Cannabis Hub ↗
1. Equianalgesic dose calculation (oMEDD)
oMEDD Calculator & Take Home Naloxone Guide
AskMyGP · browser-based · data from FPM ANZCA PS01(PM) Appendix 2 (Oct 2025)
Free, no login, runs entirely in your browser. Multi-opioid totals (e.g. MR + IR), full audit trail (every conversion shown), THN guidance auto-surfaced from the same source. Methadone, fentanyl lozenges and neuraxial opioids correctly excluded — refer to specialist for those.
FPM ANZCA Opioid Calculator app (official)
Faculty of Pain Medicine, ANZCA · iOS + Android · free
The official FPM ANZCA mobile app. Same source data as the calculator above; traffic-light dose warning system. Useful if you prefer the app on your phone. Browser landing page only — calculator itself is in the app.
2. Prescribing guidance and tapering
TGA Prescription Opioids Hub
Therapeutic Goods Administration · central index of AU opioid resources
Clinician information sheets on opioid analgesic tapering (full + summary), boxed warning text, regulatory change details, links to RACGP Drugs of Dependence, FPM PS01(PM), NSW TAG practical guidance, ROOM screening tool. The authoritative starting point.
Clinician information sheet — opioid tapering (summary)
TGA · developed with Opioid Regulatory Communication Committee (ORCC)
Practical summary of how to taper, including patient selection, rate of reduction, common pitfalls. Full version also available from the same page.
RACGP: Prescribing drugs of dependence in general practice
RACGP · Parts A1, A2, B, C1, C2, C3
The primary-care prescribing reference. Parts B (chronic non-cancer pain), C1 (opioids), C2 (benzodiazepines) most directly relevant. Authoritative for risk assessment, consent, monitoring, exit strategies.
FPM ANZCA PS01(PM) — Opioids in chronic non-cancer pain
Faculty of Pain Medicine, ANZCA · professional statement (PDF)
The specialty position on when opioids are (and are not) appropriate in CNCP. Companion to the calculator. Appendix 2 contains the opioid dose equivalence calculation table that drives the calculator.
3. Real Time Prescription Monitoring (RTPM)
Mandatory check before prescribing S8s in all jurisdictions. Each state runs its own system — same purpose, different login.
RTPM Australia — quick reference by state
AskMyGP · internal reference
SafeScript (Vic), QScript (Qld), ScriptCheckSA, ScriptCheckWA, NSW Pharmaceutical Drugs of Addiction System, ACT & Tas/NT details. Login URLs, what triggers a check, who to call.
4. Documentation & agreements
Opioid Treatment Agreement (OTA)
AskMyGP · template builder
Generate an OTA from a structured template covering goals, single-prescriber/single-pharmacy commitment, urine drug screen consent, dose limits, behaviours-for-exit clauses. Print or copy to notes.
5. Screening & risk assessment
ROOM Tool — Routine Opioid Outcomes Monitoring
NPS MedicineWise (now Australian Commission on Safety and Quality in Health Care) · PDF
Primary-care screening tool for prescription opioid dependence and outcomes. Brief; designed for use during a consult. Linked from the TGA hub.
Opioid Risk Tool (ORT)
opioidcalculator.com.au · brief 5-item screen
Pre-prescribing risk stratification for opioid abuse. Use alongside RTPM, not instead of. Higher score → consider non-opioid alternatives or specialist input.
6. PBS & regulatory context
PBS restrictions explained
AskMyGP · internal reference
How Authority, Streamlined and Restricted Benefit listings work. Opioids are tightly restricted following the 2020 regulatory changes — smaller pack sizes for acute pain, stricter indications for chronic non-cancer pain.
2020 regulatory changes (FYI): smaller opioid pack sizes (e.g. oxycodone 5 mg × 10), tightened indications away from chronic non-cancer pain except in exceptional circumstances, boxed warning required on all opioid PIs, increased prescriber accountability. Full timeline at the
TGA opioids hub.
7. Practical situations
Inheriting a patient on high-dose opioids
RACGP Drugs of Dependence Part B is the primary reference. Practical steps: review the indication and original prescribing rationale; check RTPM for cumulative dose and concurrent benzodiazepines; calculate current oMEDD via the ANZCA calculator; arrange the OTA before further prescriptions; discuss a tapering plan using the TGA clinician information sheet; document discussion and consent. Refer to pain medicine for oMEDD >100 mg/day, concurrent benzodiazepines/Z-drugs, or signs of harm.
Acute pain (post-operative or post-injury)
Smaller pack sizes (e.g. oxycodone 5 mg × 10) intended specifically for short-term use. Set expectations explicitly: opioids are for the first 3–5 days; expected weaning by day 7–14; no repeat prescriptions for acute pain without re-review. Provide a clear non-opioid analgesia plan (paracetamol, NSAID if appropriate, ice/heat, mobilisation).
Cancer pain and palliative care
The 2020 regulatory changes were not intended to restrict access for cancer pain or palliative care — these patients can continue to receive opioids at established doses, in larger pack sizes where required.
Palliative Care Australia has dedicated resources; specialist palliative-care input should be sought where available.
Methadone, fentanyl patches, neuraxial opioids
Outside the scope of the ANZCA calculator due to complex, variable pharmacokinetics — do not extrapolate. Initiation, rotation and conversion involving these agents should be done in conjunction with a pain medicine specialist or addiction medicine specialist. Methadone requires specific S8 prescribing authority in most states.
Suspected dependence or diversion
RTPM check first. ROOM tool for screening. Document clinical findings objectively. If dependence is established and treatment indicated, refer to or co-manage with an addiction medicine specialist; opioid agonist therapy (methadone or buprenorphine) requires specific authority. State alcohol and drug services accept GP referrals. Drug and Alcohol Clinical Advisory Service (DACAS) in most states provides phone advice to clinicians.
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For patients: Reducing your opioids — what to expect →
AskMyGP · plain-language companion
Why the doctor is reducing the dose, what withdrawal symptoms feel like, how to distinguish them from worsening pain, and when to call your GP urgently. No protocols.
Medication disposal — how to return unused opioids →
AskMyGP
For patients: how the Return Unwanted Medicines (RUM) project works. Pharmacies will accept unused opioids for safe disposal — free, no questions asked.