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Opioid Substitution Treatment New Zealand Practice Guidelines

Date of publication: February 2003

This has been superseded by Practice Guidelines for Opioid Substitution Treatment in New Zealand 2008


These Opioid Substitution Treatment New Zealand Practice Guidelines provide a framework for the effective, safe and responsive delivery of opioid substitution treatment and will supersede the National Protocol for Methadone Treatment in New Zealand (1996) from 1 February 2003.

Drug dependence is a condition characterised by a strong desire to repeatedly use a psychoactive substance that takes priority over other activities despite drug-related health, interpersonal and legal problems. Methadone maintenance treatment (MMT) is considered to be the effective opioid substitution treatment for most opioid-dependent people wanting to minimise harms associated with their illicit opioid use. MMT aims to minimise withdrawal symptoms, reduce opioid drug craving and reduce euphoric effects of injected opioids. For some people MMT provides an opportunity to reduce illicit drug use altogether.

There is an emphasis in these guidelines on the continuity of care that ranges from intensive intervention and active case management (stabilisation) to ongoing care in the primary health care system through appropriate general practitioners (GPs). A balance between accessibility to services and maintaining quality service delivery can be achieved when trained GPs who prescribe pharmacotherapies are able to refer clients to or consult with specialist alcohol and other drug services. No matter what setting, opioid substitution treatment will be more successful when services are accessible, entry is prompt, clinicians are non-judgmental and there is access when appropriate to allied medical, psychological, social and/or cultural services.

These Practice Guidelines acknowledge that some people may try other treatment options such as detoxification, outpatient and day programmes, attendance at therapeutic communities or other shorter-term residential services or attending self-help groups, before or during MMT. A few people may even want to use alternative pharmacotherapies.

The key principles of safety, stabilisation, assessment and review, treatment planning, clinical case management and integrated treatment are stressed in these guidelines. They also emphasise the particular skills (both professional and personal) and knowledge that reinforces the need for a trained, well-informed and accountable workforce.

Contents of this document:
Foreword
Introduction
Maori
The Treaty
Sector standards
Cultural diversity
Objectives for Opioid Substitution Treatment in New Zealand
1 Specialist Opioid Substitution Treatment Services
2 Clinical and Administrative Expectations of Specialist Opioid
3 Methadone Maintenance Treatment
4 Pharmacist Dispensing
5 Exit Procedures
6 Use of Methadone in Pregnancy
7 Treatment of Pain
8 Application for Approval to Offer Methadone Maintenance
Revocation of authority
Appendices
Appendix 1: Glossary
Appendix 2: Misuse of Drugs Act 1975 s24
Appendix 3: Pharmacokinetics
Appendix 4: Drug Interactions Associated with Methadone
Appendix 5: Selected Readings
Appendix 6: Relevant Legislation and Codes of Practice
Appendix 7: Application Forms s24(5) Misuse of Drugs Act
Appendix 8: Prison Opioid Substitution and Detoxification Protocol (Agreed May 2000)



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Opioid Substitution Treatment.pdf(PDF, 479 kB)


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Related information

Drugs in New Zealand