Changes to methadone formula coming Feb. 1

Doctors, pharmacies, agencies scrambling to get the word out to clients

Changes are coming in B.C. to a synthetic drug that is widely used to help recovering addicts. And doctors, pharmacies and agencies who help those who use it are scrambling to get the word out.

Methadone helps people who are dependent on or addicted to other drugs like morphine and heroin. As of Feb. 1, 2014, the current methadone formula given out by pharmacists will change. British Columbia will transition to a new methadone formula, called Methadose, which is expected to provide a safer, more consistent treatment for patients. But methadose will have 10 times the strength of the current formula.

Almost 15,000 people in B.C. are on methadone programs — prescribed by physicians and dispensed at pharmacies. Locally, the East Kootenay Addiction Services Society (EKASS) in Cranbrook says it has about 90 methadone clients come through its office — though that doesn’t represent all clients in the region. And the changes are a cause for concern, in that methadone users may not be aware of the vastly increased strength of the new formula.

“There hasn’t been much notification about this,” said Dean Nicholson, Executive Director of EKASS. “And the risk we see is because the volume of medication the people will be receiving will be increasing on a 10 to one basis.

“Typically, when methadone users — or illicit methadone users; people on the street who might be getting it — they’re thinking of it in terms of millilitres instead of milligrams. If they’re buying it on the street, they’re saying, ‘I’m not getting as much liquid as I normally would,’ and they might then throw more in there. But they’re actually getting a much higher dosage of the actual drug, which puts them at risk for overdose and death.

“And, obviously, the illicit street users are not going to be getting the education that hopefully people are going to be getting through supervised dispenser sites.”

Methadone is dispensed in a one-milligram-per-millilitre solution that is combined with an orange-coloured drink that clients drink at the pharmacy or take away as “carries.” Starting Feb. 1 is Methadose. The new formula comes as a red, cherry flavoured solution, pre-prepared. Patients will receive the same dose of methadone, but the amount of liquid will be one-tenth as much as what they receive with the current formula.

A release from the Government of British Columbia on Monday, Jan. 13, noted that “it is important that the public, particularly those who are on methadone maintenance therapy, be aware of the changes and take extra caution during this transition.”

EKASS is setting out to do as much public notification as possible.

“Certainly through our office we’re going to be talking to all our clients who are involved in methadone use,” Nicholson said. “We assume their prescribing doctor will be letting them know, but we’ll also be letting them know.

“But also, people who we know who might be inclined to illicit methadone use, we want to make sure we get the word out to them. They may not be as aware of the risk.

There is a third group of methadone users — those who use it for pain relief, and not because of any previous drug use.

Methadone, in fact, was developed originally as a painkiller during the 1940s, due to a shortage of morphine during the Second World War. During the 1960s, it was found it was helpful to people withdrawing from opioid addictions, namely heroin.

Nicholson said that because people who use methadone for pain relief aren’t necessarily as “drug savvy, in a sense,” they may be inadvertently at risk if they’re not being informed of the changes as well.

“Often, they may be given more ‘carries’ than some of our drug-using clients,” Nicholson said. “Many of our clients who are drug dependent may have to do daily pickups. They can’t be trusted with five days worth of carries. But if you’re dealing with some kind of chronic pain issues, and you’re on methadone and you’re given a week or two weeks worth of carries at a time, and you’re a bit confused, and might combine them.”

EKASS doesn’t completely manage those clients who use methadone for pain. Those clients deal directly with methadone doctors’ offices.

Deb Summers, Harm Reduction Manager at East Kootenay Addictions Services, encourages clients to contact her at the office, or their pharmacist or doctor for more information.