Dr. Richard Healy:

The changes would include regular care plans, regular interaction with a doctor, bespoke treatment plans based on who you are as a person, what your goals are and where you want to be, as opposed to these standardised treatment plans that are thrown onto these 12,000 people. Urine analysis should be taken away altogether. There is no empirical evidence that it does any good. Ward, Mattick and Hall have produced literature that it does not deter drug use in any way. I know as a former service user that it certainly did not stop me. It costs between €5 million and €7 million a year to test samples. That money could be put anywhere else. The key is a good therapeutic dynamic between you and your doctor, who knows you and what you want, and that you are being properly dosed. We have this stereotype of a methadone client who is walking around the inner city and the boardwalk stoned. Let us just use the word stoned. That is not methadone. Methadone does not impair how you feel unless you are abusing it in some way, adding on street tablets or whatever. That is usually done because the staff are not trained properly. That is accepted by the doctors I know who work in the HSE and who actually train people themselves.

The changes would include better training, better, more individualised care plans, and regular updates on what the person needs for care. Urine analysis should be completely eliminated. There should be more of a personal touch in a plan. I know from 20 years of engagement with methadone services that I was never asked once, "How are you doing today?" I will not use the word for what I was asked. I was told to go to the toilet in this hub and that they would deal with everything from the results of that urine sample.