New Zealand Practice Guidelines for Opioid Substitution Treatment 2025

The New Zealand Practice Guidelines for Opioid Substitution Treatment provide clinical and procedural guidance for specialist services and primary health care providers who deliver opioid substitution treatment (OST). They are issued by the Director-General under section 24A(8) of Misuse of Drugs Act 1975 and reflect our collective commitment to delivering high-quality, evidence-informed equitable care.

These updated guidelines incorporate significant developments in OST provision. They strengthen the emphasis on people’s rights, empowering people to make decisions and support recovery. They reflect legislative changes which enable nurse practitioners, designated nurse prescribers and pharmacist prescribers to provide OST, and allow for signature exempt prescriptions and extended supply periods through electronic systems. The guidelines also offer updated clinical advice on buprenorphine induction, pregnancy care, transitions from methadone, and the use of long-acting injectable formulations.