Opioid Substitution Therapy (OST) is the most common treatment for people with opioid dependence and has a substantial evidence base for effectiveness in achieving positive outcomes. The opioid maintenance prescribing options in Fife are methadone, buprenorphine and buprenorphine with naloxone. The aim of OST is to provide holistic pharmaceutical care for patients and to promote recovery by:
- Providing person centred support to patients in terms of clinical care associated with the patient’s recovery care plan, monitoring and providing intervention when required.
- Sharing appropriate information regularly with Fife wide treatment and recovery services, particularly NHS Fife Addiction Services in support of the patient’s recovery care plan.
- Dispensing OST as prescribed and according to GPhC standards.
- Provide pharmaceutical care (including supervision and dispensing of medication) and public health interventions to meet patient needs and refer or signpost to ensure access to further assessment and intervention from relevant health, social care and third sector services.
- Promote patient safety and support appropriate harm minimisation strategies, contributing to a reduction in drug-related harms within our communities. This includes ensuring the availability of naloxone for emergency administration and signposting or referring patients to services able to provide Take Home Naloxone or through existing Take Home Naloxone community pharmacy SLA.
OST Patient Support
Community pharmacy teams play a vital role in supporting patients on OST, often being the first to notice changes in behaviour or wellbeing. Timely communication with addiction services is essential—especially if a patient misses three consecutive doses, frequently misses doses, appears intoxicated, or shows signs of deteriorating health.
To make this easier, a new OST communication module is now available on NEO360, allowing pharmacies to raise concerns quickly and securely at any time with addiction services—even outside office hours or when phone lines are busy. This ensures concerns are addressed promptly, helping keep patients stable and supported in their recovery.
A demonstration video and user guide can be accessed below:
Addiction services can also be contacted using the details below:
- Telephone: 01592 716446
- E-mail: fife.addictionservicesadmin@nhs.scot
Take Home Naloxone service
The Take Home Naloxone (THN) service allows community pharmacies to offer overdose awareness training and naloxone kits to people at risk of an opioid overdose. Patients who receive OST would be deemed at risk of an overdose so should be offered this service. Community pharmacies can use an OST checklist to ensure their OST patients have been offered naloxone.
Furthermore, if a patient was to experience an opiate overdose they will be unable to administer naloxone to themselves so it is encouraged to offer the THN service to someone in their network (i.e. friends or family members).