Changes to methadone program carry no benefit

Regarding your article on a new formula for methadone (“Changes coming for a ‘life-saving’ drug” – Mirror, Jan. 21), it is difficult to comprehend the thinking behind this change.

There is no question that the tenfold higher concentration makes the medication far more dangerous for those (nearly 15,000) Canadians to whom it is prescribed, as well as non-patients to whom it might be diverted. While the greatly heightened risk applies to all forms of ingestion, the most dangerous route of administration is by injection, and it clearly is much easier to inject a lethal dose contained in a teaspoon, for example, than in a glass.

And the upside of such a conversion? There does not appear to be any. The claim you attribute to the Ministry of Health that the new product would “reduce the risk of errors” seems to lack either empirical or theoretical support. All in all, this appears to be a change that carries little, if any, benefit but could and almost certainly shall prove lethal in some cases. It should be reconsidered.

Robert Newman, MD, MPH

President Emeritus, Beth Israel Medical Center

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