OST Protocol

Opioid Substitution Treatment (OST) protocol is treatment for opioid dependency with methadone and buprenorphine/naloxone medications.

Any GP wishing to provide OST protocol to opioid dependent persons must undertake training as provided by the Irish College of GPs in order to get a HSE contract. There are two levels of OST GP prescriber.

Any GP wishing to provide OST protocol to opioid dependent persons must undertake training as provided by the Irish College of GPs in order to get a HSE contract.

• A Level 1 GP prescriber can treat stabilised opiate dependent persons in their own practice
• Patients may be referred from HSE Drug Treatment Centres, satellite clinics, or Level 2 GPs
• Ideally, the patient would be attending this GP for all his/her primary care requirements

Step 1 - Online Training: Foundation Course in Addiction

• Access the Foundation Course in Addiction Management
• On successful completion, please save your certificate and retain for your records.

Step 2 - Apply to your local HSE Addiction Services Manager for a contract

This application should include: 

• A copy of your Level 1 Certificate
• Evidence of your registration on the GP Specialist Register
• Once contract is signed go to step 3.

Download list of HSE Addiction Services Managers

Download list of  GP Coordinators

Step 3 - Contact your local GP Coordinator

Contact your local GP Co-ordinator to start the process of taking on patients.

Please be aware that an annual audit is a contractual obligation.

A Level 2 GP is trained to provide a comprehensive assessment, initiation of treatment where appropriate, stabilisation maintenance of OST treatment and/or detox of an opioid dependent in the primary care setting. Inter-GP referral of opioid dependent persons between Level 1 & Level 2 GPs is encouraged.

To be eligible to progress to a Level 2 OST prescriber, a GP must be already practising at lLevel 1.

You must achieve the following:

• Completed at least one successful online audit
• Completed the Certificate in Addiction Management in Primary Care
• Agree to commence their first five inductions of treatment under the supervision of a mentor

Please note; GPs working in HSE addiction clinics or in the prison setting are eligible for Level 2 accreditation on completion of the steps outlined below. Clinical audit can be conducted on the patients they are treating in their respective setting.