Dáil Éireann debate -
Tuesday, 17 Feb 1998

Vol. 487 No. 3

Written Answers. - Methadone Dispensing.

Marian McGennis

Question:

196 Ms M. McGennis asked the Minister for Health and Children the number of people who are receiving methadone or physeptone from a pharmacy (details supplied) in Dublin 8; and the way in which it is proposed to reduce the numbers in accordance with the new guidelines which he announced. [4067/98]

Minister for Health and Children (Mr. Cowen)

The information requested by the Deputy is not readily available since prescriptions for methadone can be prescribed on the general medical services scheme or by private prescription. It would not be appropriate to request information about such prescriptions except in the context of an official inquiry into the prescribing practices of particular general practitioners in accordance with the Misuse of Drugs Acts, 1977 and 1984. Information is, however, readily available in relation to the number who are attending this pharmacy and are being dispensed methadone in accordance with the protocol for prescribing methadone. The number involved is 31.

The Deputy will be aware that recommendations concerning the prescribing and dispensing of methadone to opiate misusers have been circulated to all pharmacists and general practitioners following a report by an expert group set up to assess the use of methadone treatment in opiate misuse. The group's report examines specifically 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. With a view to implementing these recommendations my Department has written to each general practitioner and pharmacist nation-wide requesting that they become involved in the protocol as required. In line with this strategy the Eastern Health Board is actively recruiting additional general practitioners and pharmacists in each community into the treatment of drug misusers and my officials are in continuous contact with the board regarding drug treatment service developments in the Dublin 8 area. So far satellite clinics have been established at Fatima Mansions, Dolphin House and Merchants Quay. As new doctors and pharmacists come into the methadone scheme, it is expected that this will reduce the number of drug misusers who visit any individual general practitioner's surgery or pharmacy and relieve the problems associated with high numbers.

The report recommends that patients attending any general practitioner or pharmacist should be from the immediate locality. In addition it proposes limits on the numbers attending any individual general practitioner or pharmacy. It acknowledges that in order to encourage more general practitioners and pharmacists to become involved in the scheme, appropriate supports such as training must be put in place. Under the terms of the scheme proposed in the report any person seeking a prescription must be registered with the central treatment list, must have a treatment card with a name of a general practitioner and a named pharmacy, and may only receive methadone from that pharmacy. This should also lead to restricted numbers attending pharmacies participating in the scheme and thereby reduce social problems associated with congregations of large numbers of addicts. A committee, comprised of 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 and will allow for the more even distribution of treatment thus relieving the problems arising in the area mentioned by the Deputy.