Methadone alternative on the cards according to HSE

An alternative to methadone for people addicted to heroin and related drugs could be more widely available within the first quarter of the year, according to the HSE.

Suboxone, produced as a tablet and typically taken under the tongue, is used as a treatment for patients with dependence on opioid drugs like heroin, morphine, and codeine. In late 2014, the HSE signalled it would consider reimbursing Suboxone for patients in the public health service.

According to the HSE, new legislation is required in order to provide for the re-imbursement of Suboxone in Ireland and “this legislation is scheduled for consideration in 2016”.

A HSE spokesperson said: “There are a number of clients currently being dispensed Suboxone on a pilot basis. Further expansion in the use of this treatment will be dependent on changes in legislation. In the event of necessary legislative change occurring, it could be reasonably expected to see increases in Suboxone use as a primary treatment option for new presenters to addiction services.

“It is not envisaged that widespread discontinuation of methadone prescription will follow any introduction of Suboxone treatment.”

The level of access to Suboxone treatment is yet to be determined and would be based on individual treatment needs.

According to the HSE, Suboxone is estimated at an additional drug cost of €2,186 per person, per year within the HSE Addiction Centre, based on a daily average of 80mls methadone/16mg Suboxone.

However, some in the area of drug treatment provision have suggested Suboxone should be available in the community, for example, via GPs, and not just through drug treatment clinics as this would help reduce any stigma attached and make treatment more accessible to patients who would not otherwise attend a drugs treatment clinic.

There have also been calls for an adequate budget for the reimbursement of Suboxone to ensure wider access.

Last year it was reported that €55m was spent on methadone maintenance over the period 2011 to 2014 inclusive, and that 3,300 patients were on methadone for 10 years or more.