Recovering addicts on the methadone program are being warned about a new formula hitting the market next month that is 10 times stronger and could carry a higher risk of overdose.
On Feb. 1 pharmacists will start giving out a formula called Methadose, covered under PharmaCare, which the Ministry of Health says provides a safer, more consistent treatment for patients.
Patients will receive the same dosage but will only have to ingest a 10-millilitre dose of the liquid, which is about two teaspoons, instead of 100 millilitres, just under half a cup.
The government said while the current methadone formula needs to be compounded by a pharmacist, the new formula does not, which means it will reduce the risk of errors associated with manual compounding.
Dr. Ailve McNestry, who oversees the province’s methadone program for B.C.’s College of Physicians and Surgeons, said there has to be a strong education campaign to prevent methadone users from becoming confused and drinking 100 millilitres of the stronger formula, which could result in a serious or fatal overdose.
“There are risks that people will forget,” she said, adding that many people who rely on methadone are recovering from drug addiction and may be suffering from mental illness.
Methadone is extremely toxic, McNestry said, and an overdose could cause the person to stop breathing. “The pharmacist will be absolutely key in this transition because they are the ones actually handing the medication out to the patient,” she said.
About 13,500 people in B.C. are on the methadone program to treat addiction to opioids such as heroin.
The new formula is red and has a cherry flavour that distinguishes it from the previous orange liquid. It does not have to be refrigerated, unlike the old formula.
Victoria pharmacist Sukhi Lalli said he’s been trying to make his methadone patients aware of the changes, and hangs a poster from the B.C. Centre for Disease Control that outlines the differences in colour and dosage.
More vulnerable patients, such as people who are homeless, have to go to a pharmacy every day to drink the formula, but others who are considered more stable are given several days’ worth to take at home.
Lalli said about half of his 40 methadone patients drink the mixture in the pharmacy under supervision and half are given several days of dosage to carry away. “There’s new regulations that we have to dispense each dose in a separate bottle,” Lalli said. “Now it’s mandatory because of this concern of overdosing.”
McNestry said the stronger formula makes it even more crucial for patients to lock up the medication, to prevent children from accessing it. “Because it’s red it looks awfully like a lot of cough medicine. A relative or a babysitter, if it’s not locked up, could [give it] by mistake. And for a child it could be fatal in very low quantities,” she said.
Heather Hobbs, co-ordinator of outreach and harm reduction services for AIDS Vancouver Island, said the agency has been trying to tell clients about Methadose. Some people might obtain methadone without talking to a pharmacist, such as buying it on the street, she said.
“A lot of the folks we work with don’t often have regular contact with a physician or pharmacist … and some people have challenges with literacy,” Hobbs said, stressing that beyond expecting people to read a poster, outreach workers are trying to have face-to-face conversations with people. “We are concerned about the potential risk for overdose if people don’t understand the changes.”
This is a corrected version of this story.
