According to a Health Research Board report on drug-related deaths for 2013, the latest year for which data is available, the total number of drug-related poisoning deaths increased from 361 in 2012 to 387 in 2013. Methadone was implicated in 93 poisoning deaths in 2013, compared with 86 in 2012. However, the majority of poisoning deaths where methadone was implicated, involved other drugs. There is clear evidence to indicate that having access to drug treatment is one of the major factors in reducing drug-related deaths.
Suboxone is a medicinal product comprising the drugs buprenorphine and naloxone. It is authorised as a substitution treatment for opioid drug dependence, within a framework of medical, social and psychological treatment. It is currently being provided to a cohort of patients involved in the piloting and feasibility study for Suboxone.
At the request of the Department of Health, the HSE set up an implementation group to determine the conditions to govern the wider availability of buprenorphine/naloxone products for opioid substitution therapy. In January 2016, the HSE submitted its report to the Department. The report recommends the phased increased access to buprenorphine/naloxone for a cohort of patients in specific circumstances, including the resources required, subject to the required legislation being enacted to provide buprenorphine/naloxone on the same statutory basis as methadone. If the provision of Suboxone is to be made on this basis, any regulations made in relation to Suboxone will need to be drafted subsequent to the legislative agenda associated with the Misuse of Drugs (Amendment) Bill 2016.
Methadone maintenance treatment is a critical stabilising treatment, which is the most appropriate substitution treatment for the majority of patients. Naloxone is an opioid antagonist which is used to reverse the effects of overdose of opioids such as heroin, morphine and methadone and has been proven to be an effective way of reducing the number of opioid overdose deaths. In May 2015, the HSE undertook a demonstration project to assess and evaluate the suitability and impact of using a pre-filled Naloxone injection which is designed for non-medical administration in Ireland. The project involved 600 opiate users receiving take-home naloxone on prescription. It also included those recently released from custody who have been identified as at high risk of opioid overdose. These drug users and those close to them have been trained on how to administer naloxone and to recognise the signs of an overdose. The HSE has advised that an evaluation of the demonstration project has been completed and a national implementation plan is currently being developed.
