Did A New Methadone Formula Worsen The Opioid Crisis In Canada?

By Paul Fuhr 09/12/17

One researcher claims that the change in formula is “one of the contributing factors to people overdosing from fentanyl or fentanyl-adulterated drugs.” 

hand holding a dose of cough medicine

As if recovery weren't hard enough, people in recovery from heroin addiction in British Columbia are struggling with some unprecedented challenges. According to CTV News, a change to methadone’s formula has created some unexpected, deadly wrinkles in the opioid crisis.

The formula, widely known as “Methadose,” released in 2014, was designed to be safer and more effective. That, however, hasn’t proven to be the case for people with addiction. Countless Methadose patients are now caught in the grip of a drug that they claim does not work. 

The CTV News article focuses on members of the B.C. Association of People on Methadone, a support group intended to help people with addiction for whom Methadose has failed. One member of the group named Brad Williamson said that though Methadose is much stronger than methadone, it's not as long-lasting and he was left feeling "dope sick" once symptoms of withdrawal began.

Interestingly, when the drug was released, medical experts weren’t worried about people with addiction—instead, many public service warnings were issued for everyone but them. The red, cherry-flavored formula raised concerns since “it looks awfully like children’s cough mixture,” not to mention the fact that it doesn't need to be refrigerated. (Methadone does.)

Despite being pitched as a safer, simpler alternative to methadone since it doesn’t need to be pre-mixed or compounded (which reduces the risk of an overdose), Methadose has reportedly caused its fair share of issues in British Columbia.

Williamson observed that the new formula resulted in a life that’s nearly as unmanageable now as it was when he was using: “Before, even if I missed a day or even two or three days on the old methadone, I would be fine but now if I miss one day I am in full-on withdrawal,” he said. “On the old stuff, I was able to work and pay my rent. On the new stuff I feel like a slug and I can't keep a job.”

Laura Shaver, the association’s head, is taking an even harsher stance. As she’s struggled to stave off her withdrawal symptoms on Methadose, Shaver believes the problem is far worse than being “dope sick” or not being able to hold down a job. She claims that British Columbia health officials “expect up to 1,500 people” to fatally overdose by the end of 2017, “based on 780 deaths between January and June.” 

Many Methadose users experience withdrawal symptoms as early as 14 hours, the article claims, which only sets people with addiction up for failure. In fact, Shaver herself relapsed on heroin. “It doesn't make sense, and all I know is it ruined a lot of lives and it still is, and it's also when I think the major start of the fentanyl crisis was because it was when all these people who weren't using had to go out and self-medicate again," she told CTV News.

And given the fallout from Methadose they’ve reportedly seen across British Columbia, some experts are starting to agree.

One researcher said there’s ample evidence that people in Vancouver, for one, have had negative experiences with the formula change, claiming that it’s “one of the contributing factors to people overdosing from fentanyl or fentanyl-adulterated drugs.” Similarly, a spokesperson for the B.C. Pharmacy Association told CTV News that the switch from methadone to Methadose echoes the transition from OxyContin to OxyNEO a few years ago—observing that since OxyNEO was more difficult to crush and abuse, all it did was pave the way for fentanyl. 

According to the Ministry of Mental Health and Addictions, nearly 18,000 people in British Columbia are currently being treated with Methadose. Still, the drug ranks second behind Suboxone in terms of what physicians prefer to prescribe. Suboxone, a narcotic used to treat pain and help curb heroin cravings, has fewer side effects than Methadose.

Regardless, members of the B.C. Methadose support group claim they couldn’t even make the switch to Suboxone because they felt they “couldn’t tolerate tapering down their Methadose dosage and felt they were headed for relapse.”

Overall, recovering heroin addicts in British Columbia face the very real, if not cruelly ironic, possibility that what’s supposed to save them might bring them right back to where they started.  

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.