Stronger methadone comes with caution

Switch in formula brings benefits, transition risks for recovering addicts

B.C. is changing the formula of methadone that’s prescribed for recovering heroin addicts.

The new formula that will be provided effective Feb. 1 is called Methadose and is a liquid pre-mixed at a concentration 10 times stronger than the old one, which arrived at pharmacies as a powder to be mixed into an orange-flavoured drink.

Health ministry officials say it will offer safer, more consistent treatment, but issued a bulletin Monday cautioning people on methadone maintenance therapy to be aware of the dosage change and ensure they drink only one tenth as much of the new formula.

Posters about the new stronger cherry-flavoured formula are also going up in some areas.

“We’re saying ‘Think before you drink,'” said Mykle Ludvigsen of the College of Pharmacists of B.C. “There are a lot of advantages to moving in this direction.”

Because the new formula is pre-mixed, health officials expect to reduce errors and the risk of overdose from manual mixing.

He said there’s been extensive training of pharmacists ahead of the change.

Ann Livingstone of the Vancouver Area Network of Drug Users (VANDU) said she suspects the change aims to stop some pharmacies from watering down the methadone they dispense and skimming off a bit of the powdered drug to sell separately.

“It can’t be monkeyed around with,” she said of Methadose. “But because it’s 10 times more concentrated it can be very dangerous if people are even one millilitre out [on their dosage].”

Ludvigsen said he couldn’t comment on that claim.

Some patients were believed to be abusing the old methadone by boiling it down to inject.

Ludvigsen said the college has been assured that Methadose is “much harder to abuse intravenously.”

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