Dáil Éireann debate -
Tuesday, 3 Feb 1998

Vol. 486 No. 3

Written Answers. - Methadone Usage.

Minister for Health and Children (Mr. Cowen)

A Methadone Treatment Services Review Group was set up by my Department in January 1997. Its brief was to assess the use of methadone in the treatment of opiate dependence. The group's report examines the protocols for good practice in the prescribing and dispensing of methadone and points to appropriate controls which might be put in place. It also sets out the basis on which methadone treatment should continue to be developed and recommends a concise framework for the future operation of the scheme. The report has been circulated nation-wide to every general practitoner and pharmacist.

The report's recommendations include the following: the continuation of the central treatment list of patients being prescribed methadone. 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; the provision of a personalised treatment card to each patient — this card is in turn presented to a local pharmacist who holds it for the duration of treatment; support to GPs and pharmacists through the appointment of a GP facilitator including close liaison and communication arrangements with health board services in the event of a patient destabilising; contractual arrangements with GPs, pharmacists, etc.; the provision of supervised administration of methadone cases where a general practitioner feels the need for this; the introduction of regulations to require that the prescription and supply of methadone be restricted to official prescription forms specifically designed for the purpose; specific training and information for GPs and pharmacists on the treatment of opiate dependent persons and methadone monitoring to be placed on a statutory basis by regulation under the Misuse of Drugs Act.

A committee, comprising representatives from the Eastern Health Board, the Irish College of General Practitioners, the Pharmaceutical Society of Ireland, the General Medical Services (Payments) Board and the Department of Health and Children has been established with responsibility for implementing the recommendations contained in the report. The committee's main objective will be to ensure that all general practitioners and pharmacists providing methadone treatment, do so in accordance with the arrangements in the report.

I am confident that the implementation of the recommendations in the group's report will result in strict control on the prescribing and dispensing of methadone in the treatment of opiate misuse.