As of February 1st, 2014, the province of British Columbia changed to a new and different formulation of the lifesaving medication known as 'Methadone'. On September 1st, the province of Ontario is set to follow BC's lead, also changing MMT patients from Methadone to the newer version, known as 'Methadose'. However a portion of British Columbia's patients have already reported this new formulation is not as effective as the old version. Is Ontario headed for trouble by following BC's substitution therapy switch-up?
Currently in Ontario, Methadone comes as a powder that requires compounding by each individual pharmacy (generally at 5mg/ml) prior to dispensing the liquid to patients. In order to cut down on any possible discrepancies in the Methadone mixture strength between pharmacies, as well as to combat diversion and illegal sales, Ontario's Ministry of Health and Long Term Care announced a revised policy for the dispensing and reimbursement of Methadone through the Ontario Drug Benefit (ODB) Formulary, paving the way for the switch.
The new formulation known as 'Methadose' comes as a premixed syrup from manufacturer Mallinckrodt Pharmaceuticals, compounded at a stronger concentration of 10mg/ml, and available in two varieties; dye-free sugar-free flavourless, and cherry flavour. However the dose will still be diluted with Tang prior to ingestion by the patient.
The big question is of course, will this change cause or have any negative effects on MMT patients and their recovery? Mallimckrodt, The Ministry of Health and Long Term Care, as well as many physicians and pharmacists have all been quick to reassure patients that the transition will be smooth, and the only notable difference between the 'done and the 'dose is in volume/concentration, viscosity, colour and possibly taste.
That all sounds well and good until you begin to dig a little deeper, uncovering reports and complaints from BC's recently transitioned Methadose patients which seem to fly directly in the face of the claims of equal effiacy.
"Opiate withdrawal in the context of patients switching between oral formulations of methadone has been studied. The observed patient intolerance to switching formulations appears not to have a pharmacodynamic basis."
Regardless of the Mallinckrotd statement, this is a glaring issue. Approximately 25% of formerly stable patients are experiencing withdrawal symptoms upon switching; throwing them back into a dangerous state where they vulnerable to relapse and risks associated with use. These patients are reporting that the new Methadose is simply not holding them until it is time to receive their next dose, 24 hours later. Withdrawals can lead a user right back to the problems they originally sought Methadone treatment for, creating more problems.
So why on earth would the province of Ontario opt to switch to a formulation that is known to be causing problems amongst BC's patients? Equally troubling is the lack of patient information given regarding the switch. And it is certainly not only patients that have not been properly kept up to date on treatment changes.
How is it possible that I was the one to personally inform my Doctor of the Methadose switch? His verbatim response was "Metha-WHAT?".
This is FAR from reasassuring, Ontario Ministry of Health and Long Term Care! I, along with thousands of others, depend on this lifesaving treatment. It gives patients the chance at a functional life, free from the devastating effects of opiate addiction.
Switching to a new formulation that is reportedly throwing 25% BC's formerly stable MMT patients into a state of withdrawal isn't exactly a comforting thought for me. Why? Being a Methadone patient myself, I absolutely depend on this medication to effectively provide me treatment and relief of opiate addiction. Prior to finding Methadone treatment, I was a homeless IV drug user.
I've come a long fucking way, and I'm not exactly looking forward to the forced switch to a formulation where known problems are occurring. September 1st is the date my Pharmacy officially switches to dispensing Methadose for the treatment of opiate addiction, and I will be chronicling my experiences and sharing them with all of you here on my blog.
Heres hoping for the best...
By K. Lanktree
- Freelance Writer -
- Blog Mistress -
- Former IV Drug User -
- Methadone Patient -
- Lover of all things Harm Reduction -
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