Sustaining increased and improved access to opioid substitution treatment (OST) in Ireland: a mixed-methods study to evaluate the impact of national contingency OST guidelines on process and client outcomes, and identify quality indicators for the continued and safe delivery of OST throughout and beyond COVID-19.

People who use heroin have a risk of death six times higher than the general population. The most effective treatment for heroin use is the prescription of legal, substitution medicine, most commonly methadone. This is called opioid substitution treatment or OST. Most people in OST attend a specialist outpatient addiction service, which often involves the person attending the addiction clinic daily, or several times a week to receive their medication. Others attend a GP for their prescription, which they take to their community pharmacy to receive their medication.

People who use drugs, including those in OST may become very ill if they contract COVID-19, and they may be more likely to contract COVID-19 if they are living in crowded accommodation or on the streets. Therefore, the usual services had to change quickly so that people in OST could continue to receive their medications, and other services such as counselling, without having to go to an addiction clinic or their GP as regularly as before. That way they had less risk of contracting or spreading COVID-19. Also, services had to act quickly to start people, who were not already in treatment, on OST. While these changes may be good for a lot of people in OST, we don’t know if 
they are good for everyone.

In this study, we want to look at the impact of these changes. For example, do people starting OST during COVID-19 stay in treatment and are waiting times to enter treatment getting shorter?  We also want to reach an agreement with all people involved (people who use drugs, their doctors, pharmacists, outreach workers, service managers and counsellors) on what changes are safe to continue to ensure addiction services in Ireland are patient-centred and promote the health and well-being of all people who use drugs

Award Date
26 June 2020
Award Value
Principal Investigator
Dr Gráinne Cousins
Host Institution