156. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 198 of 22 June 2022, the steps being taken to progress nurse prescribing of opioid substitution therapy; the reason this has still not been developed given the urgent need for additional personnel to prescribe; if his attention has been brought to the temporary closure of a detox unit (details supplied) during the summer due to a shortage of personnel to prescribe; and if he will make a statement on the matter. [61263/22]

Minister of State at the Department of Health: Over the last three years and in response to the COVID-19 Pandemic, the HSE has examined potential mechanisms to increase access to opioid substitution treatment in order to promote the safety of individuals who were opioid dependent and at potential risk of contracting SARS CoV 2 and suffering morbidity and mortality. A research paper on the HSE Addiction Services response during the COVID-19 pandemic highlights the many adaptations to increase access and to reduce waiting lists. As a result of these innovations and changes, the HSE Addiction services and community level 1 and level 2 GPs are providing Opioid Substitution/Agonist Treatment (OST/OAT), to an additional 1,000 individuals in October 2023, as compared with January 2020. The number of GPs prescribing buprenorphine-based products has increased from 37 to 61 in this period.

To determine whether these new changes and new guidelines should be retained post pandemic, the HSE conducted a National Delphi study in conjunction with the RCSI to obtain consensus recommendations for OST/OAT following the introduction of emergency clinical guidelines in Ireland during the COVID-19 Pandemic. The Delphi study drew together a multidisciplinary group of clinicians who were directly working in OST/OAT services in conjunction with people who were in receipt of OST/OAT and key workers. There was representation from specialist addiction services, primary care, homeless services, prison services and service users. This research examined the potential mechanisms to increase OST/OAT provision in the community and looked at all aspects of the current situation. The study produced 16 consensus recommendations, none of which identified nurse prescribing as a potential mechanism to expand OST/OAT provision.

The majority of opioid users (73%) are aged between 35 and 65 years. This aging population is more susceptible to infection, overdose and suicide and present with higher rates of degenerative disorders, circulatory and respiratory problems, diabetes, hepatitis and liver cirrhosis than their drug using peers. This population therefore requires an accessible collaborative approach, within which GPs are ideally positioned to provide comprehensive care. The ultimate aim is to have an individual receiving  OST/OAT as part of routine care delivered by their GP.

Based on the above, I am satisfied that there is currently no objective need for the introduction of nurse prescribing of OST/OAT. This matter will be kept under review by the HSE, informed by the needs of service users.

As the issue of the temporary closure of a facility is a service matter, it has been referred to the HSE for direct reply to the Deputy as soon as possible.