Recommendation 48

The Government accepts this recommendation and is already supporting the further rollout of long-acting buprenorphine. 126 local authorities provide long-acting buprenorphine as a treatment option to their population. From the end of 2021–22 to the end of 2022–23 NDTMS recorded an increase of 200% in the proportion of opioid clients being treated with long-acting buprenorphine in England. The NICE recommended a balance between methadone and buprenorphine in their 200718 technology appraisal, meaning that both these two medicines are required to be available as options for maintenance therapy in the management of opioid dependence. It is the responsibility of a patient’s clinician to decide, with the patient, which drug is most appropriate for their treatment based on a number of factors. NICE reviewed their recommendation in 2016 and concluded there was no new evidence that affects their recommendations in the guidance. However, they have since agreed that OHID could, with their endorsement, develop updated guidance that helps clinicians and patients make decisions in the light of new products and new evidence. We recommend that the Government replicate Scotland’s medication- assisted treatment standards in England to ensure that a consistent, minimum standard of care is available to people accessing opioid substitution treatment. In doing so, the Government must first consult stakeholders in the medical and drug treatment and recovery sectors on adapting opioid substitution treatment standards in a manner appropriate to England.