Canada - Drug users say methadone formula switch contributed to B.C.'s opioid crisis

[S.J.B.]

Drug users say methadone formula switch contributed to B.C.'s opioid crisis
Camille Bains
CBC
September 3rd, 2017

Drug users trying to quit heroin are gathered for a meeting in Vancouver with one mission in mind: to support each other through the struggles of a reformulated treatment drug they say hasn't worked and has instead contributed to the opioid epidemic.

Brad Williamson, 34, sits on a couch with other members of the B.C. Association of People on Methadone as they discuss how a "forced" switch to Methadose drove many to relapse on heroin.

He says the new formula was 10 times stronger but didn't last as long before withdrawal symptoms kicked in and left him "dope sick."

Williamson says he became hooked on heroin after suffering chronic leg and knee pain from 15 years as a flooring installer but entered a methadone treatment program from 2011 to 2013 before returning to using the opioid.

When he restarted treatment in 2014, British Columbia no longer offered the drug that a pharmacist would mix daily for patients from its powdered form into a sweet orange drink. A new cherry-flavoured liquid replacement called Methadose wasn't as effective, Williamson says.

Read the full story here.

 

[Fresco]

Why didnt they just keep the old formula?? Its been around forever, I highly doubt many people were injecting it

 

[Jabberwocky]

I'd be interested in learning what racemix it was, D/L and in what ratios. I quite like levo-methadone.

 

[JessFR]

Why didnt they just keep the old formula?? Its been around forever, I highly doubt many people were injecting it

I know people who do, having drunk it with it's disgusting excuse for what I can only guess is supposed to be cherry flavor, seeing someone shoot it disgusts me.

Il admit I have done it. Once, in a very specific circumstance where it was that or withdrawal. That's the only time, it wasn't too bad but it still grosses me out.

Regardless, I've never heard of methadose but it's not rocket science that if it doesn't last as long this will happen. And people relapsing is more dangerous than the few who inject it.

 

[Fresco]

I know people who do, having drunk it with it's disgusting excuse for what I can only guess is supposed to be cherry flavor, seeing someone shoot it disgusts me.

Il admit I have done it. Once, in a very specific circumstance where it was that or withdrawal. That's the only time, it wasn't too bad but it still grosses me out.

Regardless, I've never heard of methadose but it's not rocket science that if it doesn't last as long this will happen. And people relapsing is more dangerous than the few who inject it

So how are we gonna stop this fentanyl/Methadose crisis???

 

[somnilicious]

Interesting... I remember them making the switch at my methadone clinic. When they started to dose us with methadose I do remember that things in my life quickly went down hill from there. I heard all the clients bitching about it at the clinic but at the time I bought into the assurances of the staff even though I felt off. I believed them when they told me it was the same just like a generic. It didn't seem to hold me as well. I never felt right. My sleeping started to suffer. I attributed all this at the time to the fact that I had been on methadone for yrs now and because I had a habit of buying an extra bottle off a friend to double dose once a week. Around this time I started buying a couple of more bottles a week off a friend and soon after I was taking benzos, shooting and smoking coke/crack. I was soon in rehab, jail and then back on methadone at a private doctor.

I was just reading a discussion on a health forum where they were discussing this where a guy was claiming a German study indicated that methadose has a lot less of the D-isomer. It was also interesting to read in that same discussion that the D-isomer of levorphanol is dextromethorphan.

 

[S.J.B.]

I was just reading a discussion on a health forum where they were discussing this where a guy was claiming a German study indicted that methadose has a lot less of the D-isomer.

All methadone in the U.S. (and presumably Canada) has always been racemic, so it can't be that. It seems like the only significant difference here is the concentration of the methadone in solution, the higher concentration of Methadose presumably causing the drug to be absorbed and subsequently clear at a significantly faster rate. That seems far-fetched, but I'm not sure what else could be happening.

 

[somnilicious]

All methadone in the U.S. (and presumably Canada) has always been racemic, so it can't be that. It seems like the only significant difference here is the concentration of the methadone in solution, the higher concentration of Methadose presumably causing the drug to be absorbed and subsequently clear at a significantly faster rate. That seems far-fetched, but I'm not sure what else could be happening.

I know it has always been racemic but they were claiming the mixture was disproportionate. I don't know how that works. I thought that all racemic mixes were 50/50. They also threw up different theories related to slow time release and such but no studies were linked to this. I don't have the time nor the desire to research it right now though so this is all conjecture and hearsay.

 

[S.J.B.]

I know it has always been racemic but they were claiming the mixture was disproportionate. I don't know how that works. I thought that all racemic mixes were 50/50. They also threw up different theories related to slow time release and such but no studies were linked to this. I don't have the time nor the desire to research it right now though so this is all conjecture and hearsay.

Racemic mixtures are indeed always 50:50.
There's no way that the manufacturer was accidently enriching the Methadose in one enantiomer. It's likely that the study mentioned was simply misconstrued by the person posting about it.