Services Database Supervised Consumption (Herefordshire Area)

Service Outline

• For the purposes of this specification, medicines for the management of opioid dependence
  which may have consumption supervised include:
  o Methadone 1mg/1ml oral solution SF and standard (trade name Physeptone®)
  o Buprenorphine 2mg and 8mg Oral Lyophilisates (trade name Espranor®)
  o Buprenorphine 400microgram, 2mg and 8mg sublingual tablets (trade name
  Subutex®)
  o Buprenorphine/Naloxone 2mg/0.5mg and 8mg/2mg tablets (trade name Suboxone®)
  Other medication may be included within a local specification but the Opioid Substitution
  Treatment (OST) medications outlined above will form the core of most supervised
  consumption services.
• The trained pharmacist or a suitably trained member of the Contractor team6 are required to
  supervise the consumption (when prescribed or required) of the prescribed oral OST
  medication at the point of dispensing in the pharmacy, ensuring that the dose has been
  consumed by the service user.
  • For methadone: It is expected that the service user should be asked to drink some
  water and speak after the dose to demonstrate the dose has been swallowed. For buprenorphine oral lyophilisates: The oral lyophilisate should be observed being
  place on the tongue. Each oral lyophilisate should dissolve within 15 seconds and the
  service user should not swallow for 2 minutes after taking the dose.
  • For buprenorphine sublingual tablets: A minimum of 3 minutes should be spent
  supervising the service user as dissolution of the sublingual tablets may take several
  minutes. Buprenorphine may also be crushed to aid absorption. However, the
  Company does not encourage this off-licence process and, if used, the service user
  should be aware this is off-licence use and a Contractor Standard Operating Procedure
  (SOP) should be in place. Pharmacists and/or Contractor owners are also advised to
  check this is covered within their Professional Indemnity Insurance