Dáil Éireann debate -
Tuesday, 30 Sep 1997

Vol. 480 No. 6

Written Answers - Methadone Treatment Programme.

Róisín Shortall

Question:

318 Ms Shortall asked the Minister for Health and Children the reason for the delay in approving a protocol for the dispensing of methadone; if his attention has been drawn to significant problems arising due to the absence of regulation in this area; and if he will give a commitment to address this issue as a matter of urgency. [15016/97]

Minister for Health and Children (Mr. Cowen):

The report of the Expert Group on the Establishment of a Protocol for the Prescribing of Methadone set out recommendations for the involvement of general practitioners and community pharmacists in methadone maintenance programmes. It recommended that general practitioners should become involved by taking on responsibility for the care of opiate dependent persons who had first been stabilised at community drug treatment centres. It also outlined the criteria necessary to ensure that methadone prescribing occurred in a controlled, responsible fashion. Many elements of the protocol have been implemented. Most notably, a central treatment list of patients being prescribed methadone has been established. Under this arrangement a general practitioner who is considering prescribing methadone for a patient can check whether the patient's name is on this treatment list and so minimise the possibility that the patient concerned is receiving methadone from more than one source.

In order to proceed with the implementation of the protocol a methadone maintenance pilot project, involving general practitioners and pharmacists in the Eastern Health Board region, commenced in 1996. It involved the selection of a number of patients who had been stabilised in drug treatment centres and who were referred to general practitioners in their own local area for continuation of methadone treatment and overall medical care. This pilot programme included the key elements of the protocol which were: the provision of a personalised treatment card to each patient - this card was in turn presented to a local pharmacist who held it for the duration of treatment; support to GPs and pharmacists through the appointment of a GP facilitator; close liaison and communication arrangements with health board services in the event of a patient destabilising; and contractual arrangements with GPs, pharmacists etc. Although the final results of the pilot programme have not been published, preliminary results show it was successful in providing a controlled system for the prescribing of methadone to opiate misusers.

In January 1997 in the light of the evaluation of the pilot programme and also arising from the major developments in the Eastern Health Board in regard to the provision of treatment services for opiate misusers, my Department set up a group to review methadone treatment services for opiate misusers. The review group set out a number of recommendations aimed at ensuring that the necessary supports and controls were in place to allow general practitioners and pharmacists to become more involved in methadone treatment programmes. The group's recommendations are now being implemented.