Dáil Éireann díospóireacht -
Thursday, 25 May 1995

Vol. 453 No. 5

Written Answers. - Treatment for Drug Misuse.

Desmond J. O'Malley

Ceist:

11 Mr. O'Malley asked the Minister for Health if he will respond to criticism by delegates to the IPU conference in Cork when they expressed alarm that a methadone maintenance Protocol for pharmacists has been delayed for two years; and if he will make a statement on the matter. [9456/95]

Minister for Health (Mr. Noonan,

Limerick East): The Government Strategy to Prevent Drug Misuse, which was published in 1991 advocated that treatment for drug misusers should be provided in their own community in so far as is possible. It was envisaged that general practitioners would be involved in providing this community based treatment, including the prescribing of methadone while pharmacists would be involved in dispensing.

In order to lay the groundwork for the greater involvement of general practitioners in the treatment of drug misusers, it was necessary to devise guidelines for the prescribing of methadone by such practioners. An expert group, representing my Department, the Eastern Health Board, the Drug Treatment Centre, the Irish College of General Practitioners and the voluntary drug treatment sector was established, therefore, with the aim of setting out Protocols for the treatment of drug misusers. The report of the Expert Group on the Establishment of a Protocol for the Prescribing of Methadone was made available in March 1993.

The expert group made a number of recommendations relating to co-ordination and liaison between the statutory and other agencies to ensure that the prescribing of methodone was carried out in a controlled and secure manner.

One of the key recommendations in the report was that a central treatment list of all patients on methadone maintenance should be established. Following receipt of the expert group's report officials of my Department commenced discussions with representatives of the appropriate agencies to establish a list, in the first instance, of those on methadone maintenance with the Eastern Health Board's satellite clinics and the Drug Treatment Centre. This list, together with agreed Protocols for adding to or taking from the list, was completed in the summer of 1994, with in excess of 600 patients on the list.

The next step was to add to the list the names of patients on methadone maintenance with general practitioners and the expert group's report was circulated to each general practitioner in the Eastern Health Board area in September 1994, accompanied by a letter from the chief medical officer of my Department. The letter referred to the establishment of the central treatment list and requested that any general practitioner prescribing methadone for a drug misuser should check that such patient was not already in receipt of methadone by consulting the authorities operating the list and, this being so, should supply details of the patient, in the strictest confidence, for addition to the list. The letter emphasised that the expert group's report offered the necessary support and protection to any general practitioner involved in prescribing methadone, provided this was done in consultation with the statutory agencies.

Since that letter issued a total of 14 general practitioners have come forward with details of over 400 patients on methadone maintenance. My Department will be reminding general practitioners by letter in the near future of the need to comply with the recommendations contained in the expert group's report.

I am aware of the concern of the Irish Pharmaceutical Union about the need for strict control over the availability of methadone and I share that concern. For this reason my Department has been proceeding in a step-by-step basis with implementing the recommendations made by the expert group. It is intended to continue to try to involve more general practitioners in the treatment of drug misusers and as part of that process, discussions will be held with representatives of the Irish Pharmaceutical Union to allay any concerns they might have.

The Deputy can be assured, that this matter is receiving my Department's close attention. It is important that we work towards involving a number of general practitioners in prescribing methadone. This will help reduce the waiting lists for treatment which have built up at the Drug Treatment Centre and the satellite clinics. It will also lead to a more even spread of pharmacists dispensing methadone.