QUESTION to the Minister for Health (Leo Varadkar)
For WRITTEN ANSWER on 13/11/2014
To ask the Minister for Health if his Department or the Health Service Executive have examined the effectiveness of methadone as a treatment for heroin addiction; if he will provide details of the deaths linked to methadone overdose; if alternative treatments to methadone have been considered; and if he will make a statement on the matter. Jerry Buttimer T.D.
Methadone maintenance treatment is a critical stabilising treatment that enables people involved to counter their drug problem use and to rebuild their lives. Government policy in relation to drugs, emphasises the need to provide opportunities for people to move on from illicit drug use to a drug-free life where that is achievable. However, different people in various circumstances may require different approaches to treatment and support.
Methadone maintenance treatment in conjunction with other services and supports, such as counselling, training, rehabilitation and after-care, provides a pathway to recovery for the individual affected by problem substance use. A National Drugs Rehabilitation Implementation Committee, chaired by the HSE, is overseeing the national roll-out of an integrated inter-agency model of care in order to ensure that a person can access the range of services required to support their recovery.
In their 2014 annual report, the European Monitoring Centre for Drugs and Drug Addiction state that in Europe an estimated 734,000 opioid users received substitution treatment in 2012 with methadone being the most commonly prescribed substitution medication, received by up to two-thirds of substitution clients, while buprenorphine is prescribed to most of the remaining clients (about 20 %). Methadone is the principal substitution medication in six countries within the EU, including in Ireland.
The National Drugs Related Deaths Index report, published on the 21st January 2014, shows deaths up to 2011, the latest year for which data is available. These figures indicate that there was a substantial increase in the number of deaths where methadone was implicated, with 113 such deaths reported in 2011 compared to 60 in 2010. However, the majority of these deaths (86%) involved poly-substance poisonings. In addition, 68% of those deaths where methadone was implicated, were not in opiate substitution treatment at the time of their death. Data including deaths in 2012 will be available early next year.
An Opioid Substitution Implementation Group has been established by the HSE to develop a plan for facilitating the wider availability of buprenorphine products as an alternative to methadone in the treatment of opioid dependence. The Group comprises representations from the HSE and the Department of Health including medical professionals with specific interest in addiction. I understand that the HSE is currently in discussions with the supplier company in relation to the pricing structure relating to the product. The outcome of these discussions will inform the recommendations of the group.