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After meetings with @hakique & I, the Government of Canada is now warning about switching methadones. "A safety review completed by Health Canada has found that there may be a link between switching methadone...and the risk of lack of effect." https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2020/73547a-eng.php
Switching itself may well cause problems. The medical community has been aware of “change intolerance” since way before people started getting their methadone switched in Canada. Seems reckless to have done this at all. But I digress.
But the biggest problem for us is that some formulations do not have legs (Methadone, Sandoz blue methadone) and some do (compound, Metadol-D). Not having legs is how we describe something that whose effectiveness drops off too quick.
Dr. Sutherland (PHS medical director) told me that raising people's Methadose dose didn’t work. "So, people tried going up on the dose, or splitting the dose. Or, um, trying other medications. But just...I didn’t come up with any great solutions to help people in the moment."
But Health Canada now advises doctors to raise the dose if patients are dopesick. This is wrong. Doctors should offer alternatives to Metahdose. And Health Canada must ask itself: is it promoting tools for fighting the overdose crisis that are compromised?
This bulletin from Health Canada tells people that SWITCHING is the risky part. And this may actually dissuade doctors from offering to switch someone off of Methadose and on to an alternative formulation of methadone. No methadone uses were consulted on the drafting of this.
BACKSTORY: Over the last 6yrs, Thousands of methadone patients across Canada were switched to a big pharma formulation which does not seem to last as long. https://crackdownpod.com/podcast/episode-2-change-intolerance/
Last month, Laura Shaver @shaverlaura4 filed a potential class action lawsuit against the government of BC, the College of Pharmacists and the manufacturer of Methadose, alleging this contributed to overdose fatalities. https://crackdownpod.com/podcast/episode-17-class-action/
