Wow, does time ever fly. The year 2016 is gone, and 2017 is here! It's been quite some time since I've posted, and I've had several of you reach out to make sure things are alright; so I wanted to take a quick moment to update everyone on how things have been going. TL;DR: Things are good! I can't complain, anyways.
For those of you who've never experienced what it's like to down a dose of Methadone, let me give you a quick idea; it's best taken all in one go, like you would a shot of Tequila. If you pay attention to the patients just after they've ingested their Methadone, you'll often catch a few of the faces puckering up in reaction to the bitter taste. When the dose itself is prepared by the pharmacist, it must be diluted prior to being dispensed to the patient. But the amount of liquid added as a diluting agent can pose problems for some patients when it comes to downing their dose...and keeping it there.
The 1st of September has finally come and gone, and here in Ontario it marked the arrival of a new formulation of Methadone by Mallinckrodt Pharmaceuticals know as 'Methadose'. There has been plenty of discussion regarding the switch and it's negative impacts in B.C.; some vehemently opposed to the change, others standing firmly behind the position that there is absolutely no difference between the two formulations. However I no longer have to go by second hand accounts, as I have now officially made the Methadone to Methadose switch myself.
Changes Are Afoot
When I began hearing about the changes to the Methadone formulation in B.C. as well as the problems being raised by patients, my reaction was mixed. My first thoughts were those of empathy, discontent and relief. I truly felt for those patients in B.C. who were not adjusting well to the switch, and experiencing painful withdrawals. I was very unimpressed with the Province for making changes that are putting peoples hard earned recovery and sobriety at risk. However if I'm being honest, I was also completely and utterly relieved that there was no mention of Ontario in this switcharoo.
Just a few short months later while at the pharmacy for our daily dose of Methadone, Mr. L mentions he overheard discussion about something called 'Methadose' and changes to Methadone, and asked me if I had heard anything of it. As soon as the word 'Metha-DOSE' left his lips, my heart sunk. Fuck. I shook it off, and hoped to hell what he had just overheard did not pertain to us. I was just itching to hop on my bike and get myself home so I could dig into the treasure trove of information that is Google - searching for anything and everything remotely related to Ontario and Methadose.
The search results revealed exactly what I didn't want to see. The Ontario Ministry of Health and Long-Term Care had indeed made the decision to change from the current formulation of Methadone to Mallinckrodt Pharmaceuticals 'Methadose' as of September 1st, 2014.
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.
By K. Lanktree
- Freelance Writer -
- Blog Mistress -
- Former IV Drug User -
- Methadone Patient -
- Lover of all things Harm Reduction -
Help keep 'Studio L' online by donating to help offset the costs! Thanks💋