Opioid Substitution Therapy – Introduction of Buprenorphine or Buprenorphine/Naloxone

The Misuse of Drugs Regulations 2017 (SI 522 of 2017) allow for the use of buprenorphine containing products as part of Opioid Substitution Therapy. The Opioid Substitution Treatment Prescription Form has been amended to reflect this change.

Access to buprenorphine as part of the Opioid Substitution Treatment programme is being introduced by the HSE on a phased basis. It should be noted that methadone remains the drug of choice in opioid substitution.

Pharmacists should be aware that the principles of clinical governance and safe patient care, as set out in the PSI Guidance for Pharmacists on the Safe Supply of Methadone (Undergoing update to reflect 1 March 2024 legislative amendments) apply equally to the supply of buprenorphine products in Opioid Substitution Therapy. If you are providing this service, it may be useful to review the following sections of the guidance:

• Section 4. Code of Conduct
• Section 5. Guidance (including Initiation, Patient Registration, Storage, Counselling and Vaccination)
• Section 7. Policies and Procedures

Pharmacists providing such services should also consult the HSE Clinical Guidelines for Opioid Substitution Treatment, which provide clinical advice in this area.

It is also essential that pharmacists be aware of, and engage as needed, with their local addiction services supports, including the relevant addiction services support pharmacist where available.

This update was included in Issue 4 of the PSI Newsletter (October) 2018