Printer-friendly version

This research was commissioned by the Department of Health, Social Services and Public Safety (DHSSPS) on behalf of the Northern Ireland Drugs and Alcohol Campaign in response to the number of problem heroin users presenting for treatment in Northern Ireland.¹

The report, conducted by Dr Karen McElrath, reviewed literature on substitute prescribing for opiate dependence. It focused largely on heroin use and covered both clinical and observational studies. Although most research has focused on methadone, the review includes findings from studies that compared methadone, buprenorphine (Subutex) and, to a lesser extent, Levo-Alpha-Acetyl Methadol and heroin maintenance. 

The review found evidence suggesting that methadone treatment can increase treatment retention, reduce subsequent opiate use and reduce drug-related criminal activity. It also concluded that higher treatment retention rates were associated with a philosophy of maintenance rather than abstinence or reduction. 

The report recommended that the use of methadone maintenance be made available as a treatment option for individuals dependent on heroin. With evidence of favourable results on the long-term effects of the drug, the report also recommended the implementation of buprenorphine treatment for maintenance purposes. The report recommended that heroin maintenance should not be offered as a treatment option. 

The evidence reviewed showed favourable results in terms of effectiveness for the shared care model and it was recommended that this model be implemented in treatment protocols for Northern Ireland.  

To download the full report "Review of Research on Substitute Prescribing for Opiate Dependence and Implications for Northern Ireland" and the response to its recommendations from the DHSSPS click here.

Subsequently, the DHSSPS established a Substitute Prescribing Implementation Group, with representation from service users, providers and commissioners, to progress the implementation of substitution prescribing services on a Northern Ireland wide basis. In 2004, the DHSSPS published Northern Ireland guidelines on substitution treatment for opiate dependence.²

To download the "Northern Ireland guidelines on substitution treatment for opiate dependence" click here.

Reference

1. McElrath K. (2003) Review of Research on Substitute Prescribing for Opiate Dependence and Implications for Northern Ireland Karen McElrath, Queen’s University, Belfast with a Response to the recommendations contained in the Review from the Department of Health, Social Services.
2. Northern Ireland guidelines on substitution treatment for opiate dependence. Belfast, Department of Health Social Services and Public Safety, 2004.