This document contains practical and evidence-based advice for clinicians on best practice for the clinical assessment and treatment of clients with opioid dependence. They replace the guidelines that were published in 2008.
New Zealand Practice Guidelines for Opioid Substitution Treatment 2014 will replace the Practice Guidelines for OST published in 2008 and New Zealand Clinical Guidelines for the Use of Buprenorphine (with or without Naloxone) in the Treatment of Opioid Dependence (Ministry of Health 2010). In addition, it incorporates the documents Prescribing Controlled Drugs in Addiction Treatment: section 24 Misuse of Drugs Act 1975 (Ministry of Health 2013) and National Guidelines: Interim methadone prescribing (Ministry of Health 2007).
As previous guidelines have done, these guidelines strongly endorse a path that moves away from a maintenance-treatment model and towards client-led, recovery-focused treatment. They also outline a series of important developments in the provision of OST, including:
- clear advice for practitioners about ‘driving while impaired’, with reference to the Land Transport Amendment Act 2009 and checklist for evaluating a person’s ability to drive safely
- information on the funding of buprenorphine (with naloxone), which has given consumers a welcome choice in their treatment options, while also deterring substance misuse and diversion
- The Te Whare o Tiki framework, which guides the mental health and addiction workforce in effectively responding to the needs of people with complex and co‑existing problems.
These guidelines aim to highlight the importance of early transition planning, with an emphasis on transitioning stable clients to primary level care. In line with the Health and Disability Services (Core) Standards (NZS 8134.1:2008), the overriding principle of this document is that provision of OST is person centred and recovery orientated.