The implementation of the Misuse of Drugs (Supervision of Prescription and Supply of Methadone) Regulations, 1998, which came into operation in October, 1998, provided for the establishment of a central treatment list, imposing strict controls over the prescribing and dispensing of methadone. In addition methadone could only be dispensed to patients registered on this list who held a drug treatment card. These regulations were necessary in order to prevent inappropriate prescribing of methadone, which, in some cases, was resulting in its availability on the illicit market.
Leading up to and following the introduction of the regulations a small number of general practitioners, who prescribed to large numbers of patients did not become involved in the methadone scheme. As a consequence, their patients have had to be accommodated at treatment centres around the Dublin area. The numbers registered in treatment at the end of August, 1998 was 3371, the numbers registered in treatment has continued to rise to 3,829 at 17 May 1999. There are now 100 general practitioners and 155 community pharmacists participating in the scheme.
Methadone is now provided at 40 Eastern Health Board treatment locations, 19 of which were established in 1998, and through general practitioners. During 1998 the Health Board provided an additional 715 treatment places in its services. Because of the increased availability of treatment locations, the demand for treatment has increased, causing an increase in the waiting list. The waiting list for treatment at 31 August 1998, prior to the introduction of the methadone regulations was 500. Services for these people could only be provided at five locations. The current waiting list is 618, but 11 treatment locations now deal with the waiting lists. The board is presently involved in an exercise to validate waiting list figures.
The increase in numbers in treatment and the increased participation by general practitioners and community pharmacists demonstrate that the methadone protocol has not contributed to delays in treatment.
The demand for treatment continues to grow, however, as treatment facilities continue to be developed. The Eastern Health Board's service plan for 1999 includes the provision of additional treatment locations aimed at eliminating waiting lists and providing treatment to people in their own local area.
