BACKGROUND:
In
British Columbia, Canada, methadone maintenance treatment formulation
transitioned from the oral liquid compound Tang™-flavoured methadone to the
ten-times more concentrated cherry-flavoured Methadose™ in February 2014. We
quantitatively describe perceptions and reported consequences among a sample of
patients on methadone maintenance treatment following this transition.
METHODS:
A
province-wide survey was used. Bivariable analyses utilized independent samples
t-tests, Phi associations, and Chi-square tests. Multivariable logistic
regression analyses evaluated factors related to dependent variables - namely,
increases in dose, pain, dope sickness, and the need to supplement with
additional opioids.
RESULTS:
Four
hundred five methadone maintenance treatment patients from fifty harm reduction
sites across British Columbia reported transitioning to Methadose™ in February
2014. The majority (n = 258; 73.1 %) heard about the formulation change
from their methadone provider or pharmacist. Adjusted models show worse taste
was positively associated with reporting an increasing dose (OR = 2.46;
CI:1.31-4.61), feeling more dope sick (OR = 3.39; CI:1.88-6.12), and worsening
pain (OR = 4.65; CI:2.45-8.80). Feeling more dope sick was positively
associated with dose increase (OR = 2.24; CI:1.37-3.66), and supplementing with
opioids (OR = 8.81; CI:5.16-15.05).
CONCLUSIONS:
Methadone
maintenance treatment policy changes in British Columbia affect a structurally
vulnerable population who may be less able to cope with transitions and loss of
autonomy. There may be a psychosocial component contributing to the perception
of Methadose™ tasting worse, and increased dope sickness, pain, and dose. Our
study shows the pronounced negative impacts medication changes can have on
patients without informed, coordinated efforts. We stress the need to engage
all stakeholders allowing for communication about the reasons, risks and consequences
of medication policy changes and provision of additional psychosocial support.
University of
British Columbia, School of Population and Public Health (http://spph.ubc.ca/), 2206 East Mall,
Vancouver, BC V6T 1Z3 Canada
BC Centre for
Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4 Canada
Simon Fraser
University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
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