New Clinical Guidelines for Opioid Substitution Treatment 

The HSE has launched new Clinical Guidelines for Opioid Substitution Treatment.  In Ireland, Opioid Substitution Treatment (OST) refers to the provision of both methadone and buprenorphine/ buprenorphine-naloxone to patients. At the end of 2014, there were 9764 people in receipt of OST in HSE Addiction Clinics and GPs, compared with 9,116 in 2013. The number of patients receiving methadone from pharmacists as part of OST has almost doubled in the past decade. At the end of December 2013, there were 6,265 (69%) patients receiving their medication in 628 pharmacies, compared with 3,740 (58%) patients in 329 pharmacies at the end of 2003.

The guidelines highlight that the dispensing pharmacist is often the member of the multidisciplinary team who interacts with the patient most frequently for the supervised consumption of their medication. It is essential that there is regular communication and/or meetings between the pharmacist, the prescribing doctor and any other relevant healthcare professionals involved in a patient’s care. These provide an opportunity to discuss patient care and any issues the pharmacist or medical practitioner deems necessary to ensure the patient receives an appropriate standard of care.

The guidelines have been developed to outline evidence-based care, to standardise and improve the quality and safety of care to patients. They are the first national guidelines applicable in HSE treatment clinics as well as primary care, and update and replace the 2008 ICGP guidelines ‘Working with Opiate Users in Community Based Primary Care’.

The guidelines were developed by a committee which included representatives from the PSI, the College of Psychiatry of Ireland, the Irish College of General Practitioners, HSE Addiction Service Managers, and chaired by a representative from the National Social Inclusion Office.

All pharmacists involved in the supply of methadone, buprenorphine/buprenorphine-naloxone for the management of opioid substitution treatment should read and follow these guidelines to ensure they are providing optimal care for their patients.