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Health Service Executive: The Introduction of the Opioid Treatment Protocol

20th December 2010

The HSE has recently published the Introduction of the Opioid Treatment Protocol, a wide ranging review of the Methadone Treatment Protocol (1998), which examines the current regulatory processes and oversight arrangements for opiate dependence treatment in Ireland.  It is the first comprehensive external review following a consultation process with key stakeholders.

The Introduction of the Opioid Treatment Protocol aims to maximise the provision of treatment, facilitate client progression pathways and encourage heroin users to engage with treatment services. The provision of opiate replacement treatment helps those with heroin dependency to stabilise their lives and to begin the process of addressing their addiction.

The report indicates that there has been a major expansion in delivery of drug treatment to prisoners. However, there is a need to link this up with the community based services. It is essential to address the capacity of community drug service provision in order to ensure that users in prison get access to longer term treatment. There are a significant number of users in prison who do not receive ongoing treatment in prison because of the inability of the prison services to ensure ongoing access to treatment after release. 

Julian Pugh, Co-ordinator of Drug Treatment Services (Prisons), commented in the report that "risk issues need to be addressed in relation to short terms prisoners who commence a methadone detoxification programme on admission to prison and are released without continuity of care being in place. Releasing prisoners without continuity of clinical care or continuation of methadone is very risky. This is particularly so regarding Dochas releases".

The Irish College of General Practitioners also made a submission to the report, stating the important of ensuring linkages between prison services and ongoing treatment after release: "Patients are often transferred via a telephone call with no follow up documentation/transfer summary forwarded to the family/Level 1 GP. Communication from the prison service when clients are being discharged is particularly random. Due to the high risk of overdose on discharge from prison, communication from the prison authorities to the treatment agencies or GP should be made a priority".

Soilse (Service Users) also commented on Methadone is prisons: "If you’re on maintenance before your sentence you will get a maintenance when you go in. Medical units can only house 9 people (5,000 prisoners), it can sometimes take up to 6 months to access a bed in there. More places are needed. Groups and meetings would enhance a recovery culture. There is counselling services available, but not everyone can avail". 

This report clearly shows that there are a significant number of users in prison who do not receive ongoing treatment because of the inability of the prison services to ensure ongoing access to treatment after release. There is a need for better linkages between services and for ensuring priority access of prisoners to community based treatment after release from prison.

Read more:

  • See the full report here