Frequently asked questions about methadone and buprenorphine for DHI clients in South Gloucestershire.
Methadone and buprenorphine are opiate substitutes which help reduce withdrawal symptoms and cravings for opioids (like heroin or codeine). Alongside the medication you will be offered psychosocial and behavioural therapies to help provide you with the ability to manage cravings and cope with any other challenges you are facing. Lots of people find that taking methadone and buprenorphine enables them to stabilise and provides an opportunity to focus on their housing, work, or their health and wellbeing.
Yes, only some GPs are signed up to be part of the shared care service at DHI. Most GPs will not prescribe methadone/buprenorphine without DHI. Please check with DHI for an up to date list of GP surgeries who are registered with the Primary Care Team.
You will need to go to your GP surgery to collect the prescription. You can then take it to your preferred pharmacy. Your DHI worker will check the pharmacy has availability for daily supervised pick up. Everyone who starts a new prescription will start on daily supervised. This means you need to attend the chemist every day and take the methadone/buprenorphine in front of the pharmacist. This is to ensure your safety whilst getting used to the medication.
If after you have been taking the medication for a few months, you want to reduce your supervision to daily pick-up or weekly take home you can ask your DHI worker for a review. As part of this review you will be required to have a drug test which shows that you are taking the prescribed medication, and not taking additional illicit substances. You will also need to be attending the pharmacy as planned, and engaging with your DHI worker regularly so that we can ensure you are safe and well.
We encourage people to go to groups to get extra support during their recovery. Groups provide an opportunity to meet other people in treatment, and also provide information to help underpin your recovery and teach you skills and coping mechanisms to manage triggers, cravings and relapses. We currently have online groups via zoom, and online self-help called Breaking Free Online.
Most people who access support are working towards abstinence. DHI can support you to prepare physically and emotional for a community or inpatient detox. If you require a detox you will firstly complete our detox group programme to give you the skills and knowledge to ensure your detox is successful. In the groups you will learn the skills and coping mechanisms you will need to maintain abstinence and recovery after the detox. DHI work with a number of organisation to provide the clinical assessment and medication. The usual timeframe from initial triage assessment to accessing a detox is around 12 weeks to enable you time to get ready.
If you’ve only missed 1 or 2 days, please go to your pharmacy as usual, and they will be able to continue your script. If you have missed more than 2 days (3 days+), you will need to complete a new urine drug test. DHI will then request a new script from your GP which may include titration back up to the level you were previously prescribed at. It can take up to 5 days to get a urine testing appointment, and around 48 hours following your drug test to start a new prescription. This is to ensure you are safely prescribed and there is no risk of overdose.
If you are going on holiday you should let your key worker know as soon as possible. Most GPs will require at least a weeks’ notice and will require evidence of your holiday. Evidence could include accommodation booking confirmation or a travel ticket.
Methadone and buprenorphine are controlled under the Misuse of Drugs legislation in the UK. This means that extra legal controls apply to these medicines. You may need a personal licence to take controlled medicines abroad. Specific requirements may also apply to the information that you must take with you and how you carry your controlled medicines. You could get a fine or go to prison if you travel with medicine that’s illegal in another country. We therefore recommend you check with the embassy of the country you want to go to, before booking. Your GP will be able to provide evidence that you are prescribed the drug however there may be a charge for the letter, and this can take a number of weeks.
Please let your key worker know if you think you might be pregnant, or have completed a positive pregnancy test. Your key worker will request extra support for you, for our specialist team. Please do not change or stop taking your medication. It is safe to continue taking it and they can be continued during pregnancy because it carries a lower risk of harm to the fetus than the use of illicit drugs.
