In 2007/8 a PRI subgroup developed protocols on how community, voluntary and statutory services could work together with GPs to provide methadone and benzodiazepine community detoxes with wrap-around medical and psycho-social supports.

These protocols have been established with the intention of ensuring that individuals who wish to detox without attending a residential establishment, or in preparation for attending one (as methadone prescriptions need to be reduced to 30 – 50mls before admittance), will have appropriate supports.

Best practice in the U.K states that for community detox to be effective ‘clear referral criteria and entry points’ need to be established in policy. In the Irish / local context the advantages of clear and consistent systems for clients to request and engage in outpatient detox may be beneficial in further establishing community detox as a formalised progression pathway. The Scottish experience also highlights the need for integrated care management and the need for the involvement of multiple agencies in a co-ordinated manner. U.K guidelines also recommend that clients ‘should play an active role in the monitoring of their own health and healthcare' (Guide 5 – Community Detox. Effective Interventions Unit, Substance Misuse Division, Scottish Executive).

The protocols provide guidance on stakeholder roles and responsibilities, including those of the Service User, GP and Key Worker or Case Manager. It’s important to note that detox brings serious risks of intolerance and overdose, and requires careful clinical assessment as well as cohesive social supports and a clear care plan.