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Dáil Éireann debate -
Thursday, 15 Feb 1996

Vol. 461 No. 6

Written Answers. - Methadone Treatment Programme.

Frances Fitzgerald

Question:

65 Ms F. Fitzgerald asked the Minister for Health the progress, if any, made in relation to the implementation of the 1993 Expert Group report on a Protocol for the prescribing of methadone; and if he has satisfied himself regarding the progress made on the report; when this report will be implemented; and the number of drug addicts he expects to avail of the treatment. [3408/96]

Frances Fitzgerald

Question:

66 Ms F. Fitzgerald asked the Minister for Health the number of addicts in Dublin to whom the methadone maintenance programme will be available in 1996. [3409/96]

Frances Fitzgerald

Question:

67 Ms F. Fitzgerald asked the Minister for Health the number of drug addicts in Dublin currently availing of methadone maintenance programmes. [3410/96]

Frances Fitzgerald

Question:

68 Ms F. Fitzgerald asked the Minister for Health if he will consider research into the effectiveness of methadone maintenance treatment programmes; and his views on research from other countries on the success of such programmes. [3411/96]

Frances Fitzgerald

Question:

69 Ms F. Fitzgerald asked the Minister for Health the number of general practitioners currently involved in the methadone maintenance programme. [3412/96]

Limerick East): I intend to deal with Questions Nos. 65, 66, 67, 68 and 69 together.

International research has shown that it is possible to reduce the anti-social behaviour of intravenous drug misusers by taking them into treatment on methadone maintenance programmes. I am satisfied that such programmes are a valid and successful part of an integrated response to the problem of heroin abuse.

The report of the Expert Group on a Protocol for the prescribing of methadone set out recommendations for the involvement of general practitioners in methadone maintenance programmes. The Protocol recommended that general practitioners should become involved by taking on responsibility for the care of drug misusers who had first been stabilised at community drug treatment centres. It also outlined the criteria necessary to ensure that methadone prescribing occurs in a controlled, responsible fashion.

Many elements of the Protocol have already been implemented. Most notably, a central treatment list of all patients being prescribed methadone has been established. A general practitioner who is considering prescribing methadone for a patient can check whether the patient's name is on this treatment list and thus ensure that the patient does not receive methadone from more than one source.

At present details of 680 patients for whom methadone is being prescribed by 25 general practitioners have been supplied for inclusion on the central treatment list. A further 700 drug misusers are prescribed methadone in treatment centres at Pearse Street, Baggot Street, Amiens Street and Ballyfermot.
During 1996 it is proposed to expand treatment services to drug misusers who are currently on waiting lists for such treatment. The number of additional persons for whom treatment will be provided will depend on the success of the Eastern Health Board in establishing further community drug centres in local areas and also on the number of additional general practitioners and pharmacists who are prepared to prescribe and dispense methadone respectively to stabilised drug misusers. As the Deputy will be aware, the Eastern Health Board has encountered local opposition in some areas to the establishment of treatment centres and the board is currently engaged in widespread consultation with local community groups to deal with issues of concern to them.
Plans are at an advanced stage to run a pilot programme which will allow for the full implementation of the recommendations in the Protocol. It will involve a selected number of patients who have been stabilised in drug treatment centres and who will be referred to general practitioners for continuation of methadone maintenance treatment and overall medical care. The elements which will be included in this pilot programme are:
—drug misusers, who will be referred to general practitioners, will have been previously stabilised in a health board treatment clinic,
—each patient will be provided with a personalised treatment card,
—a facilitator, appointed by the Eastern Health Board, will provide liaison between treatment centres, general practitioners and pharmacies.
—any drug misuser who becomes destablised while under general practitioner care will be referred back to a treatment centre for attention and further treatment.
The pilot programme will run initially for a six months period and it is hoped that, with the support of the appropriate professional organisations, general practitioners and pharmacists will continue to be part of the overall programme for the provision of treatment services for stabilised drug misusers in their own communities.
To date many general practitioners and pharmacists have been reluctant to become involved in the provision of services for drug misusers and I can understand that reluctance. I am confident, however, that by moving ahead with this pilot programme in a controlled, systematic manner, this reluctance can be overcome.
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