The “fragmentation” between mental health and addiction services for dual diagnosis patients has been criticised in the wide-ranging HSE review of the Methadone Treatment Protocol [1998].

Addicts who are out of methadone treatment are approximately three times more likely to die as those who are in stable treatment, states the review, pointing out that treatment has an important role in the prevention of such deaths in the community.

The report also examines the current regulatory processes and oversight arrangements for opiate-dependence treatment. There are more than 9,000 people receiving opiate replacement treatment in Ireland and the introduction of the Opioid Treatment Protocol – the “first comprehensive external review following a consultation process with key stakeholders” – aims to maximise the provision of treatment, facilitate client progression pathways and encourage heroin users to engage with treatment services. Opiate replacement helps people who are addicted to heroin to begin the process of overcoming their addiction....