Responding to a post from g&gfiorito dated 7/31/97 [#247 - Eric]:
Many clinics have switched from the use of generic methadone to an analog form called Methadose. Methadose comes in a concentrated syrup and is packaged in large brown bottles which hold 10,000 mg per bottle. It is an absolute fact that Methadose is far cheaper to purchase in bulk form than generic methadone in wafer, pill, or ampule containers. The difference in price is enough to justify, in the minds of clinic staff, the drop in quality of the medication.
I have been on maintenance for 27+ years & have been medicated with every type of methadone form known to man. The original methadone we received in 1970 from the public clinic in San Diego came in the form of a clear liquid packaged in 90mg snap-top ampules. The medicine was mixed with real orange juice in a paper cup & dispensed to us as such. This methadone seemed to have more staying power (staying in your system longer, that is) than the cherry flavored Methadose which is ubiquitous over the entire country at this time. I fully agree that the Methadose is an inferior product to the original methadone.
Additionally, I have experienced the methadone wafers, which are 40mg/wafer & are divisible into 4 separate sections. This medicine is equal to the generic clear liquid in quality. Lastly, I received the 10mg methadone tablets w/the trade name of Dolophine (which, by the way, is not named after Adolf Hitler but gets its name from the Latin dolor, meaning pain; the Nazis did create it, however, due to a lack of morphine products which resulted from Allied Forces blockading the inflow of products from other parts of the world to the Nazi regime); this form of methadone comes in small white tablets and is also of equivalent quality to the wafers and generic liquid form. I received these pills while in the hospital for an operation.
The Methadose at our clinic is, in fact, dispensed by the computer operated pump and I have noticed a definite variation of strength in the day-to-day dosages which I receive. It is my belief that air may get trapped in the pumping device, reducing the amount of Methadose dispensed, or this analog may have had its staying power reduced in an effort to chemically "breed out" the small amount of euphoria inherent in generic methadone. At any rate, it does not hold me as well as the other forms.
Also, there is a good chance that some of us have a degree of liver damage, which will impede the metabolization of the methadone. This syndrome is common among alcoholics who also take methadone; their livers will not process the methadone to the level that is needed to prevent low-level withdrawal symptoms. The only way to counter this is to take a higher dosage of methadone, or split your daily dose into 2 parts, to be taken once in the morning & once in the evening. Most clinics, however, refuse to accommodate people wishing to use their medication in this form, even though it provides a more stable level of medication in your system & avoids the "drowsy after & jittery before dosing" effect which I have both noticed in others & experienced in myself.
As far as ORLAAM is concerned, I have no experience with the product. It sounds like a good thing, but I know of no one who has actually had experience with it (and I'm not going to be the first on my block!).
I also wish to tell you that whoever said that the viscosity of the methadone product has anything to do with the dosage being dispensed is full of shit! There is a certain amount of methadone (mg per ml) contained in every milliliter of liquid and it makes no difference at all how thick or thin the liquid is. That is the most bald-face lie I have ever had the misfortune of reading. I have a degree in General Geology with a reasonable amount of background in Chemistry and I will tell you that viscosity has nothing at all to do with content, as far as the dispensing of medication is concerned. 50mg of methadone is 50mg of methadone, whether it comes in the form of a gas, a liquid, an extremely viscous liquid or a fucking rock, for that matter! I'd like to know who thought that chestnut up!
At any rate, I believe that there is a difference between generic methadone and the inferior Methadose product. If any of the patients at the various clinics around the country can prevail upon the staff to replace the Methadose w/regular methadone, the patients will be a lot happier and more comfortable. At our clinic, it is all about profits, so there is virtually no likelihood of reverting to the generic. We'll be lucky indeed if they don't force us all to start taking the ORLAAM.
Take Care, all.
Your West Coast correspondent,
Posted on: 9/21/97
Last modified on: 9/27/97