New Zealand Practice Guidelines for Opioid Substitution Treatment 2014

1. Treatment Goals:

   • Reduce harm associated with opioid use.
   • Improve physical and mental health outcomes.
   • Enhance overall quality of life.

2. Patient Assessment:

   • Conduct comprehensive initial assessments, including:
   • Physical health status.
   • Mental health status.
   • Substance use history, including opioid use patterns.
   • Social circumstances and support systems.
   • Regular monitoring and reassessment throughout treatment.

3. Pharmacological Treatment:

   • Primary medications used are methadone and buprenorphine/naloxone (Suboxone).
   • Detailed protocols for:
   • Dosing initiation and adjustments.
   • Management of medication adherence.
   • Addressing opioid withdrawal symptoms.
   • Management of side effects and adverse reactions.

4. Psychosocial Interventions:

   • Integrated approach with pharmacological treatment.
   • Include:
   • Counseling and behavioral therapies.
   • Support for social issues (e.g., housing, employment).
   • Family and peer support programs.

5. Monitoring and Review:

   • Regular monitoring of treatment progress and outcomes.
   • Assessments include:
   • Opioid use patterns and reduction.
   • Physical health indicators.
   • Mental health status and improvements.
   • Response protocols for relapse prevention and management.

6. Special Populations:

   • Tailored approaches for:
   • Pregnant women with opioid dependence.
   • Adolescents and young adults.
   • Patients with co-occurring mental health disorders.
   • Patients with chronic pain and opioid use.

7. Collaborative Care:

   • Multidisciplinary team involvement:
   • Healthcare providers (e.g., GPs, addiction specialists).
   • Mental health professionals.
   •  Social workers and community support services.
   • Coordination of care to address holistic needs.

8. Safety and Risk Management:

   • Strategies for:
   • Overdose prevention, including naloxone distribution.
   • Management of medication interactions and potential risks.
   • Education on safe storage and disposal of medications.

9. Cultural Sensitivity:

   • Considerations to ensure treatment respects cultural backgrounds and preferences.
   • Accessible services for diverse populations.

10. Legal and Ethical Considerations:

    • Guidelines on:
    • Legal frameworks and regulations governing opioid substitution treatment.
    • Ethical principles in treatment delivery.
    • Patient rights and confidentiality.

11. Education and Training:

    • Recommendations for healthcare providers on:
    • Training in opioid dependence management.
    • Continuing education on updated treatment protocols and best practices.

12. Evaluation and Quality Improvement:

    • Processes for:
    • Outcome evaluation and quality assurance.
    • Incorporation of patient feedback and satisfaction surveys.
    • Continuous improvement of treatment services.

Learn more about the Guideline