Consequences of legislative changes to methadone prescribing in Ireland

In 1998 new regulations [Misuse of Drugs (Supervision of Prescription and Supply of Methadone) Regulation, 1998; Government Publications, Dublin] obligated General Practitioners (GPs) in Ireland to have undergone a period of training before they could prescribe methadone and required collation of information about all patients treated on a Central Register. As a result of this new legislation patients who were previously being treated by private GPs, who were now no longer eligible to prescribe, were absorbed into the Health Authority’s Addiction Services during the month of October 1998. Data were collected at entry and at three months follow-up on 464 of these patients. After three months the percentage on higher dose treatment (>90mg daily) dropped from 7% at entry to 2%; those positive for illicit opiates dropped from 64% to 28% (P<0.001); and those positive for benzodiazepines dropped from 67% to 51% (P<0.001). The introduction of new legislation regarding methadone treatment has underlined the need for a multi-disciplinary approach when treating opiate misuse. Since these regulations were introduced GPs can have access to training and support services.