Prescription Opioid Dependence in Herefordshire
Case reference FOI2026/01875
Received 5 August 2026
Published 28 August 2026
Request
I am writing to request information under the Freedom of Information Act 2000 regarding access to treatment for prescription opioid dependence within your local authority area.
Please could you provide answers to the following questions:
1. Is there a commissioned pathway within your local authority area for individuals with severe prescription opioid dependence (for example, codeine, dihydrocodeine, tramadol, morphine or oxycodone dependence) to access assessment for opioid substitution treatment (OST) where clinically indicated?
2. If such a pathway exists, which service or provider is responsible for delivering this treatment?
3. Can methadone and/or buprenorphine be prescribed for individuals whose primary dependence is on prescribed opioids rather than illicit opioids?
4. Are there any restrictions, exclusions or eligibility criteria that would prevent an individual with prescription opioid dependence from accessing OST?
5. How many individuals whose primary substance was a prescribed opioid received opioid substitution treatment within your area during the most recent 12-month period for which data is available?
6. If OST is not available for people with prescription opioid dependence, what treatment pathway is commissioned for these individuals?
Response
I am writing to request information under the Freedom of Information Act 2000 regarding access to treatment for prescription opioid dependence within your local authority area.
Please could you provide answers to the following questions:
1. Is there a commissioned pathway within your local authority area for individuals with severe prescription opioid dependence (for example, codeine, dihydrocodeine, tramadol, morphine or oxycodone dependence) to access assessment for opioid substitution treatment (OST) where clinically indicated?
Answer: The Service Area have advised yes, although this is not the primary focus of the service. The service is primarily for people dependent on illicit substances, novel psychoactive substances or alcohol. However: "Although not routine, in exceptional circumstances (e.g. when other risk factors are displayed) services should be made available for people with problems associated with the primary use of prescribed or 'over the counter' medications." The service also includes pharmacological interventions, substitute prescribing, GP shared care and specialist assessment pathways. Therefore, a pathway exists for assessment and treatment where clinically appropriate.
2. If such a pathway exists, which service or provider is responsible for delivering this treatment?
Answer: Herefordshire Drug and Alcohol Recovery Service, commissioned by Herefordshire Council and delivered by Turning Point (Services) Limited.
3. Can methadone and/or buprenorphine be prescribed for individuals whose primary dependence is on prescribed opioids rather than illicit opioids?
Answer: The Service Area have advised yes. The provision of opioid substitution treatment includes:
· Methadone
· Buprenorphine
· Buvidal (long-acting buprenorphine)
· Other evidence-based pharmacological interventions consistent with NICE guidance
4. Are there any restrictions, exclusions or eligibility criteria that would prevent an individual with prescription opioid dependence from accessing OST?
Answer: The Service Area have advised there are no explicit exclusions preventing access, but there are some limitations.
The specification states that:
· The service is primarily intended for people dependent on illicit drugs, NPS or alcohol.
· Access for people whose primary problem is prescribed or over-the-counter medication use is "not routine."
· Access may be provided in exceptional circumstances, particularly where additional risks or vulnerabilities are present.
· Clinical assessment, appropriateness and risk management determine access.
5. How many individuals whose primary substance was a prescribed opioid received opioid substitution treatment within your area during the most recent 12-month period for which data is available?
Answer: The Service Area have advised the following is taken from ndtms.net and includes information up to May 2026 (most recent data). We are unable to share a report for the past 12 months but have looked on ndtms.net and we have sat between 1 and 2 people since June 2025:
6. If OST is not available for people with prescription opioid dependence, what treatment pathway is commissioned for these individuals?
Answer: The Service Area have advised there are several nuisances with this depending on the medication being used, physical health condition and other involvement from professionals, but OST would always be offered for anyone with an opioid dependence, where clinically indicated. If someone does not wish to commence OST, then we would liaise with the GP to support alternative prescribing (i.e. pain management) or detox from prescribed medication (we may take on the detox ourselves). We would always provide appropriate and relevant harm reduction information regardless of whether the individual accesses treatment.
Documents
This is Herefordshire Council's response to a freedom of information (FOI) or environmental information regulations (EIR) request.
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