Scottish Public Health Observatory update
Estimated quarterly numbers of people prescribed opioid substitution therapy in Scotland (12-month period)

About this release

This release by Public Health Scotland (PHS) provides a Scottish Public Health Observatory (ScotPHO) update for the Drugs topic area, where the 'Prescribing for Drug Use' page contains new data.

Main points

Drugs – Treatment for Drug Misuse

• In the 12-month period ending 30 September 2023 (the end of 2023/24 Q2), Opioid Substitution Therapy (OST) was prescribed to an estimated minimum of 30,190 people in Scotland. In the 12-month period to the end of the previous financial year quarter (2023/24 Q1) an estimated minimum of 30,133 people were prescribed OST.
• The NHS Board areas where the highest estimated numbers of people prescribed OST (inclusive of injectable buprenorphine prescribing) lived were Greater Glasgow & Clyde (8,844), Lothian (4,671) and Grampian (3,053).

Background

These figures estimate the number of individuals prescribed Opioid Substitution Therapy (OST) drugs for the treatment of opioid dependence from legacy British National Formulary (BNF) subsection 04.10.03. This includes methadone hydrochloride, buprenorphine, buprenorphine & naloxone and long-acting buprenorphine (including Buvidal© slow-release formulations). Lofexidine hydrochloride and naltrexone hydrochloride (both primarily used for the management of opioid withdrawal) are not included.

These figures are based on combined data from Prescribing Information System (PIS) and Hospital Medicines Utilisation Database (HMUD) for a rolling 12-month period, which is updated each quarter. They are described as 'estimates' or 'minimum numbers' due to issues which mean that it is challenging to provide a robust count of the number of people prescribed these medications.

For PIS data, estimates for local authority and NHS Board of residence are based on the number of unique Community Health Index (CHI) numbers captured from named community prescriptions for relevant medications at any time within 12 months of each financial year quarter. However, CHI capture for OST prescriptions remains below the agreed threshold of reliability for individual-level analysis (usually only reported when CHI completeness is above 85-90%).

HMUD contains details of some long-acting buprenorphine treatments administered in community settings which are prescribed via hospital stock order forms. As HMUD does not include patient details, it is not possible to produce patient estimates in the same way as for PIS. Following consultation with specialist Pharmacists, it has been agreed that the average number of 28 day injectable buprenorphine formulations ordered per month (based on quarterly data) can be used to estimate the number of patients to whom treatment is delivered via this mechanism in each NHS Board.

The variable quality of the underlying data means that these figures, and comparisons over time, should be treated with caution. Due to the public interest in OST prescribing, these statistics are published as management information.

The Scottish Public Health Observatory collaboration is led by PHS and includes the Glasgow Centre for Population Health, National Records of Scotland, the Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit and the Scottish Learning Disabilities Observatory.

The aim of the collaboration is to make public health information more accessible, to promote the reduction in inequalities and to inform health improvement in Scotland.

Further information

Data from this publication are available from the publication page of the ScotPHO website. 

The next release of these statistics will be on June 2024.

The next ScotPHO annual update will be released in Summer 2024.