Buprenorphine (Hansard, 19 June 2003)

§ Dr. Ladyman

Buprenorphine is already included in the treatment protocols developed in conjunction with national health service services at eight prison service establishments. The prison service's standard for clinical services for substance misusers requires every establishment which receives prisoners from court to have detoxification guidelines in place for at least one of methadone, lofexidine, and dihydrocodeine. It also states that, as new evidence becomes available on the chemical management of detoxification or abstinence, establishments should develop further treatment guidelines which are in line with those available in the NHS. Prison health keeps the question of a formal trial of buprenorphine in prisons in England under review, but expects its use to develop at a similar pace to the growth in its use in the community.

More generally, the National Treatment Agency (NTA) has a responsibility to maintain the research base and to prioritise and disseminate findings to enhance 422W quality of care. Consideration of the use of buprenorphine forms part of the NTA's activity, including receiving advice from experts on prescribing issues. The NTA advocates a range of treatment options following adequate assessment of need and works with local drug action teams (DATs) to ensure an appropriate range of provision is developed locally.

There is already a body of evidence for the efficacy of buprenorphine in the treatment of opioid dependence. The level of evidence does not suggest that buprenorphine should replace methadone as a substitution treatment, but rather that buprenorphine should now be considered an evidence-based addition to the range of pharmacological maintenance treatments. Information from specialists indicates that there has been an increase in the use of buprenorphine in the United Kingdom as an alternative to methadone.