Group suggests allowing nurses to prescribe methadone

Group suggests allowing nurses to prescribe methadone

A group representing nurses trained in Substance Misuse Treatment Services has said some people can’t access proper treatment quickly enough because their members have not been given the green light to prescribe drugs like methadone.

The Health Research Board has previously said that in Ireland, where independent nurse prescribing of opioid substitute therapy (OST) is currently not permitted, the rate of drug-related deaths is high at over 3.5 times the European average.

The Irish national drugs strategy ‘Reducing Harm, Supporting Recovery, 2017-2025’ said the feasibility of nurse prescribing of OST should be explored. Previously, the Department of Health said it would satisfy the strategic objectives of Sláintecare, which include “increased access to person-centred and equitable healthcare nationally”.

However, no progress has been made towards that aim and the Ireland chapter of the International Nurses Society on Addictions said it needs to be prioritised by the next government.

Peter Kelly, board member of The Ireland chapter of IntNSA, said: “If the next government places a value on delivering safe and cost-effective treatment for people who are dependent on drugs then it is imperative that they amend the legislation around nurse prescribing of opiate substitution therapy and that nurse prescribing is fully operationalised in practice.

"Our membership informs us that people who are dependent on drugs are not able to access treatment in a timely manner with waiting lists in some community treatment services between four to six months. This is a very long time for a person with complex needs who is in the middle of an acute crisis.

In some prisons, people are not being initiated onto methadone because community services cannot provide assurances of a place in treatment when they are released.

"This all places vulnerable people at higher risk of further drug use and death. Implementing nurse prescribing of methadone and buprenorphine can address these gaps in provision and will save lives.

"We [IntNSA] estimate that there are at least 20 and possibly up to 40 fully trained and highly competent nurse prescribers working in the addiction field in Ireland, some of whom are already prescribing in a limited way, but unlike in other countries, the legislation here does not allow them to independently prescribe drugs like methadone and buprenorphine. Wasting a safe, valuable and life saving resource like this is without justification.”

Irish nurses already working in the area of drug treatment said OST nurse prescribing would be cost-effective, would reduce the risk to high-risk drug users and could open the way to the expansion of nurse-led mobile teams, including prescribers, that could help access marginalised groups.

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