Methadone and Treatment
By: Eleu Pontes CSW

Methadone is the most highly regulated and controlled area in addiction treatment, and also one of the most highly regulated in all medicine. In the eyes of the public, policy makers, as well as health and social service providers, there is an unfortunate stigma associated with methadone and people who receive
Methadone Maintenance Treatment
(MMT).

Hitler is cut of his Morphine supply.
First patented in 1947 under the name Dolophine.
Late 1950’s through the 1960’s:
Doctor and Researcher Dr.
R.Halliday.
Early 1960’s The New York
Research, By: Dr. M.Nyswander and Dr. V.Dole.

1947 Eli Lilly Pharmaceutical patient Va10820 under the name
Dolorphine in the US

Dolorphine

The Dolor is the Latin word for Pain
 The word Finis or Phine is the Latin word for End
 Dolor/ Phine or Pain/ End
 Or End of Pain

 In 1959 to early 1960’s

Opened the first ever MMTP in the world in downtown
East-side of Vancouver.
 Dr.Halliday once say Methadone is to the Addict as
Insulin to the Diabetic.

•
1995 BC is granted Provincial control over methadone prescribing & dispensing  Narcotic Control Act 1972 assigned
Narcotic prescribing (specifically methadone) to the Federal Government  Ontario followed closely behind.
 1972 Approx. 24 MMT clients in Canada
•
1996 Ontario – 700 clients

1975 due to NCA there was a 33%  in clients in treatment
 2000 Ontario --5,961 clients
 1985 further reductions in treatment
(only 1/3 rd of the 1972 numbers were still in treatment)
 2007 Ontario-16,406
 Estimated 1,000 new clients enter treatment each year in Ontario.
The College of Physicians and Surgeons of Ontario


The number of Physicians holding exemption in Ontario to prescribe Methadone is 258 as of 2007

228 hold 3 year exemptions
 30 hold 1 year exemptions

Ontario has about 10,000 Pharmacies.

3,059 are dispensing Methadone as of 2007.

358 are presenting accepting new clients as of 2007.

The Opium Poppy Plant

Opium
Historical records show the use of
Opium as far back as the 3 rd
Century BC.
The word “Opium” comes from the ancient Greek word
“JUICE”

The invention and availability of the Hypodermic Needle.

.
 A term refers to drugs deriving from the Opium Poppy
Plant.

Drugs like: Opium, Morphine, Codeine and others.

 It’s a family name.
 These are synthetic drugs.
 Drugs like Demerol, Dilaudid, Oxycodone, Methadone, and many more.
It has been estimated 80,000 regular illegal opioid users in Canada
Centre of Addiction and Mental Health 2003.


It is a synthetic opioid.

It is a slow releasing synthetic opioid.

It is taken orally.

It is mix with an orange tang mix.

It begins to take affect within 30mins.

Peak level within 4hrs.

It effect can last for 24 to 36 hrs.

Tolerance.

A 40 t0 60 mgs of Methadone can be lethal to non-tolerant adult.


In the beginning your first visit
(3 day waiting period).

Urine samples and/or Lab tests.
 Number of weekly visits.

Visit to Pharmacy and Carries.

How to achieve carries.

Lock box.


An effective treatment for opioids dependence.

Helps prevent the transmission of HIV/AIDS and Hepatitis C
Viruses.

Helps reduce Criminal Activities.

It has reduced the number of Deaths due to Overdosing.

Improves Economic Productivity.

It improves Physical and the Mental Health of the individuals.

Improves both the quality of life and outcome of pregnancies.

Every $1 spend on Methadone
Maintenance
Offers a cost belief of $4 to $13
Stoller & Bigelow, 1990 (USA) CALDATA study

 Ontario Stats

Estimate of total annual costs related to opioid addiction in Ontario = $660 million.
 Estimate of total annual cost to supply MMT all of the above = $9 million
 Based on very conservative estimate of 15,000 individuals.


The one person to offer support is their Physician.

The lack of Counseling, Therapist, and/or Social
Worker.
 Cases of positive tapering are few.

Clients feel they need to rush throw doctor appointments.

Methadone Maintenance treatment.
MMT does not cure opioid dependence: rather, it is a medical treatment that can help people manage their opiate addiction and stabilize their lives. It is not appropriate for everyone who is opioid dependent, and is only one of a number of treatment option that should be considered. When MMT is used appropriately however, it can be live-saving treatment.
Methadone Maintenance Treatment Practices Task Force. W.Anton Hart.