Patients who are on an opioid substitution treatment program. Dr James Marshall & Laura Bates

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Our aim is to provide practical and clear information to assist nurses working in these settings to better meet the needs of people with opioid dependence. We provide an overview of Opioid Substitution and its role in the treatment of addiction before moving to focus on specific considerations for patients in perioperative settings.  We discuss the medications used to treat opioid dependence and some common challenges which arise in the management of OST in the hospital setting, including consideration of systemic and individual factors from staff and patients. We will finish with some suggestions for how to implement changes in the practice setting to improve patient outcomes for this population.


Dr James Marshall is a senior psychiatric registrar completing advanced training in addictions at Canterbury District Health Board. He graduated from the University of Otago in 2016 and entered psychiatric training soon after. His interests are varied but I particularly enjoy opioid substitution therapy in pregnancy and psychotherapy.





Laura Bates trained in the UK as a Mental Health Nurse before emigrating to New Zealand in 2013. She has worked in a variety of settings but have spent the majority of my career in outpatient addiction clinics focused on providing opioid substitution treatment. She has been in her current role as  a GP liaison nurse within the Christchurch Opioid Recovery Service since March 2021.