Advice for drug treatment and recovery workers to help them to deliver safe and effective OST to service users.

• Part 1: introducing opioid substitution treatment (OST)
• Part 2: supporting service users to start opioid substitution treatment (OST)
• Part 3: supporting service users to get the most out of opioid substitution treatment (OST)
• Part 4: supporting opioid detoxification
• Part 5: resources and further reading
• Glossary 

This guide provides drug treatment and recovery workers with the information they need to deliver good quality opioid substitution treatment (OST) to service users. It will also help them have more effective conversations about OST with service users and the local multidisciplinary team, including prescribers.

Drug misuse and dependence: UK guidelines on clinical management (also known as the Orange Book) outlines UK national guidance on best practice in drug treatment including OST. 

This guide focuses on what drug treatment and recovery workers need to know in their day-to-day OST practice. It supports them to provide the best possible treatment for OST service users in line with clinical guidelines. 

This guidance includes the following sections:

1. Introducing OST: this describes how to have effective initial conversations about OST.
2. Supporting service users to start OST: this outlines how to prepare and support service users as they start OST.
3. Supporting service users to get the most out of OST: this explains how to monitor, support and review someone’s OST, and looks at what to do if someone’s OST is not working for them. It outlines the roles of drug treatment workers and the multidisciplinary team in optimising treatment or switching between OST medications.
4. Supporting opioid detoxification: this outlines how to support service users to reduce and stop OST through detoxification.
5. Resources and further reading: practical resources for day-to-day practice and other useful documents.
6. Glossary: this explains the terms commonly used in OST and drug and alcohol treatment and recovery.
7. Authors and acknowledgements. 

This guide is a product of PHE’s OST good practice programme. The programme has also developed other OST good practice resources including:

• the Best practice in Optimising Opioid Substitution Treatment (BOOST) e-learning programme, which includes short films showing typical clinical conversations between people who are on OST and their drug treatment and recovery workers
• an OST service self-assessment tool, to help commissioners and drug treatment service providers assess what they are doing and what more they could do to deliver OST in line with best practice