Dr. Bernard Kenny:

As medical practitioners, price would not come into it certainly. That is not something we ask. We would not consider that. We would consider the most appropriate treatment for that person. In certain circumstances, depending on the substances involved, different opioid agonist therapies, which is what we call methadone and Suboxone, may be more appropriate. We would always make our decisions with the patients involved. The vast majority of practitioners have moved on from a paternalistic model of care where we impose our judgments. It is all around shared decision-making now. In most practices, you would not prescribe a treatment that someone was not comfortable with, or certainly would never force somebody onto a treatment. Occasionally methadone may be the more appropriate treatment and you explain the rationale for that, depending on the risks from other substances they may be taking, interactions with medications, or certain other chronic diseases that co-exist alongside the addiction. Certain people may have advanced liver disease and other things as well and that may affect their treatment option. It should be informed shared decision-making. Certainly, the ICGP would always support that approach.