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4.10 Substance abuse 

Acamprosate Tablets - click here for shared care
Buprenorphine (Subutex) Tablets - click here for shared care see NICE TA 114
Disulfiram tablets - click here for shared care
Methadone mixture 1mg/ml - click here for shared care see NICE TA 114 
Lofexidine tablets - RED drug (Mental Health / Drug Abuse service specialists only)
Nalmefene tablets – see NICE TA 325
Naltrexone tablets - click here for shared care see NICE TA 115

Note: Initiation of the above agents should be by a specialist in substance / alcohol misuse, with counselling and supervision

Nicorette Gum, Microtabs, Patches , Inhalator, Nasal Spray
Niquitin Lozenge
Varenicline tablets - see NICE TA 123 ; see prescribing advice

1. Nicotine Replacement Therapy (NRT) is NICE approved and is first line for smoking cessation following review by smoking cessation service.

2. Varenicline (also available within the fresh start programme ONLY) can be used in patients intolerant of or who dislike NRT. It should be started 1-2 weeks prior to a quit date; a course of treatment is 12 weeks. Patients should be advised to discontinue treatment and seek prompt medical advice if they develop agitation, depressed mood, or suicidal thoughts. Patients with a history of psychiatric illness should be monitored closely while taking varenicline.


Link to BNF section: 4.10 Drugs used in substance dependence