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 hasn91裸聊视频檛 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 91裸聊视频渇orced91裸聊视频� switch to Methadose drove many to relapse on heroin.
He says the new formula was 10 times stronger, but didn91裸聊视频檛 last as long before withdrawal symptoms kicked in and left him 91裸聊视频渄ope sick.91裸聊视频�
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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, B.C. 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 wasn91裸聊视频檛 as effective, Williamson says.
91裸聊视频淏efore, 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,91裸聊视频� he says. 91裸聊视频淥n the old stuff, I was able to work and pay my rent. On the new stuff, I feel like a slug and I can91裸聊视频檛 keep a job.91裸聊视频�
Laura Shaver, who heads the association, says the impact of the change can no longer be ignored as health officials expect up to 1,500 people could fatally overdose in the province by the end of the year, based on 780 deaths between January and June.
Shaver, 39, said on methadone, her withdrawal symptoms were kept at bay for about 24 hours, but returned in 16 hours on Methadose.
91裸聊视频淚t was awful. It disrupted my whole life again,91裸聊视频� says Shaver, who relapsed onto heroin and was angry that methadone users hadn91裸聊视频檛 adequately been consulted before the change that was so dramatic.
91裸聊视频淚t doesn91裸聊视频檛 make sense, and all I know is it ruined a lot of lives and it still is, and it91裸聊视频檚 also when I think the major start of the fentanyl crisis was because it was when all these people who weren91裸聊视频檛 using had to go out and self-medicate again.91裸聊视频�
Ryan McNeil, a researcher at the B.C. Centre on Substance Use, says some Methadose users reported withdrawal symptoms in as early as 14 hours, putting them at risk of seeking illicit opioids.
He says evidence from the centre91裸聊视频檚 research involving people who access Vancouver91裸聊视频檚 overdose prevention sites suggests the switch to Methadose had 91裸聊视频渉uge implications.91裸聊视频�
91裸聊视频淚t91裸聊视频檚 an important thing to consider how the methadone formulation change functioned to impact people in the long-term in relation to their methadone treatment and subsequently has been one of the contributing factors to people overdosing from fentanyl or fentanyl-adulterated drugs,91裸聊视频� he says.
David Pavan, spokesman for the BC Pharmacy Association, says Methadose was developed to reduce the likelihood of abuse, such as injecting it versus ingesting it orally.
91裸聊视频淭his change is similar to the transition from OxyContin to OxyNEO,91裸聊视频� he says of the prescription opioid pill that became harder to crush and abuse, though that change has also been credited for creating a market for fentanyl, which made its debut in Canada in 2013 and is often shipped in small packages from China.
The Ministry of Mental Health and Addictions says 17,751 are being treated on Methadose. The methadone maintenance treatment program was administered by the College of Physicians and Surgeons of B.C. since 1996. It transitioned to the B.C. Centre on Substance Use in June, with the launch of a new treatment guideline for opioid use disorder, and is part of a treatment plan including two other drugs.
Cheyenne Johnson, a nurse and clinical director at the centre, says the new guideline recommends Suboxone as the first-line treatment because it has fewer side effects and is safer and can be taken home instead of being taken in front of a pharmacist. Methadose is recommended next, followed by slow-release morphine.
91裸聊视频淭o our knowledge, this guideline is the first kind in the world that really looks at putting all those options together,91裸聊视频� she says, adding psychological and social supports for patients are included as part of treatment.
The College of Physicians and Surgeons91裸聊视频� guideline had only methadone as a treatment option for 40 years, even though Suboxone has been available in Canada for eight years, Johnson says.
91裸聊视频淥ther countries have been using this medication since the 91裸聊视频�90s so Canada is a slow adopter overall.91裸聊视频�
Members of the methadone group, including Williamson, say their attempts to change to Suboxone were unsuccessful because they couldn91裸聊视频檛 tolerate tapering down their Methadose dosage and felt they were headed for relapse.
Johnson says there isn91裸聊视频檛 enough research on Methadose patients changing to Suboxone but the centre is considering a clinical trial to learn how patients would fare.
She agrees with Shaver, Williamson and others that the change to Methadose should have involved the people who would be directly affected.
91裸聊视频淭hat was terrible. If there was a drug that 60-year-old businessmen had to go and pick up every single day from the pharmacy you bet they91裸聊视频檇 be consulted. Because it91裸聊视频檚 vulnerable and marginalized populations it91裸聊视频檚 not the same considerations, which is not acceptable.91裸聊视频�
Camille Bains, The Canadian Press
