The Misuse of Drugs (Supervision of Prescription and Supply of Methadone and Medicinal Products containing Buprenorphine authorised for Opioid Substitution Treatment) Regulations 2017 came into effect on 22 November 2017. The purpose of these Regulations is to provide access to certain buprenorphine-based medicinal products for Opioid Substitution Treatment (including buprenorphine/naloxone (suboxone) and buprenorphine only) on the same statutory basis as methadone.
The phased rollout of suboxone commenced on 01 May 2018 and allowed for prescribing of this product by trained Doctors working in HSE Addiction service and specifically approved Level 1 and Level 2 GPs outside the Dublin region. This rollout then extended to suitably trained Level 1 and 2 GPs within the Dublin region in October 2018.
The HSE Addiction services have provided training to HSE Addiction staff and community based GPs in relation to buprenorphine containing products to include the prescribing and dispensing of suboxone on seven separate occasions since October 2017. In addition, the ICGP in conjunction with the HSE provided training to community based GPs in relation to buprenorphine and buprenorphine/naloxone in October 2018.
This has resulted in an increase in the number of patients receiving treatment for Opioid Dependence with suboxone from 118 in 2014 to 254 in 2019 (January to July).
The provision and expansion of buprenorphine/naloxone (suboxone) prescribing is in line with one of the key actions under the National Drug and Alcohol Strategy Reducing Harm, Supporting Recovery - to improve the availability of Opioid Substitution Treatments (2.1.14).
The provision of this medication is expected to continue to expand over the coming year and GPs are continually being encouraged to become trained to prescribe this medication. Further training of Community GPs will come under the remit of the ICGP who have the expertise and responsibility to provide training to GPs.