Methadone alternative to be made available to drug addicts

Introduction of Suboxone delayed because of need for specific legislation

 

An alternative to methadone for treating people with heroin and other opiate drug addictions is to be made widely available after the Department of Health agreed to provide the funding.

However, the introduction of Suboxone for people with opioid dependence is being delayed by the need for specific legislation allowing the drug to be given on the same basis as methadone.

The department said drafting of this legislation is at an advanced stage. “It is anticipated that it will be published in the coming months, with the intention of having it enacted later this year,” a spokesman said.

Suboxone costs up to 10 times as much as methadone but is less addictive and harder to abuse, so patients can take it home. Withdrawal symptoms are generally less severe and the risk of fatal overdose is lower.

Clinicians and patient groups have long been critical of the absence of an alternative to methadone, given that a majority of patients do not move on from the treatment. More than 10,000 people receive methadone as a treatment for drug addiction. Some 3,300 have been in receipt of the drug for a decade or more.

Active ingredients

Suboxone is produced as a tablet, taken under the tongue and used mainly as a treatment for patients with dependence on heroin, morphine and codeine.

It contains two active ingredients: buprenorphine, which reduces symptoms of dependency on opioid drugs; and naloxone, which guards against overdose through misuse.

Some 81 people are currently receiving the drug on a pilot basis, according to the Health Service Executive.

Ireland is one of four European Union member states where Suboxone is not available as an alternative to methadone. It typically accounts for between 20 and 30 per cent of the “market” in other European countries.

Emergency laws

The need for specific legislation arises from a court case last year which led to the State’s drug laws

being struck down for a time. The Oireachtas responded by passing emergency laws to reinstate the ban on drugs but this means any further changes can only be made by way of legislation.

The HSE earlier this year recommended the phased introduction of Suboxone despite reservations about price. An internal group found it was not a cost-effective alternative to methadone but could benefit selected patients.

The extra cost involved compared to methadone was €2,186 per patient per year, making Suboxone a “far more expensive treatment”, the group also found.

The group recommended making Suboxone available to about 500 patients a year, at a cost of about €1 million.

Regulation on the provision of the drug will be drafted once the necessary legislation is passed, according to a department spokesman.