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Opioid Substitute Treatment (OST) and risks to children: Good Practice Guide

This guide is developed from two reports produced by Adfam in 2014 and 2015 on Medications in drug treatment: tackling the risks to children.

It is designed for any practitioner who comes into contact with parents (or those living with children) using substances and their children. This includes drug and alcohol specialist practitioners, social workers, phar-macists and prescribers (medical and non-medical). The section at the end is designed for the managers of drug and alcohol specialist practitioners. Elements of particular relevance to drug and alcohol specialist practitioners are shown in purple.

It is not, and should not be considered, a comprehensive guide for child care or child protection practice, nor for the treatment of drug and alcohol problems, nor for all aspects of parental substance use.

This guide is aspirational; while this is the standard to which all those involved should be aiming towards, we recognise that increasingly agencies are under pressure and may not have the resources needed to comply with this guide fully.

It is also important to recognise that OST is an extremely valuable tool in the fight against drug addiction, and we are clear that the evidence base supports its part in our treatment system. The overwhelming ma-jority of the people who need and use OST do so safely. However, we also must recognise that the drugs used – especially methadone – are toxic, powerful and a clear danger to children when stored or used in-correctly by their parents and carers, and it is for this reason that we have developed this guide.