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Prevalence and Correlates of Intravenous Methadone Syrup Administration in Adelaide, Australia

NCJ Number
200590
Journal
Addiction Volume: 98 Issue: 4 Dated: April 2003 Pages: 413-418
Author(s)
Rachel Humeniuk; Robert Ali; Catherine McGregor; Shane Darke
Date Published
April 2003
Length
6 pages
Annotation
This study examined the prevalence of methadone syrup injecting in Adelaide, South Australia, and characterized methadone injectors, including their heroin use and risk behaviors associated with heroin overdose.
Abstract
Although orally delivered methadone has proven to be a safe and effective method of maintaining opioid-dependent individuals while decreasing the risk of heroin overdose and other adverse effects associated with heroin addiction, there are concerns that methadone syrup intended for oral consumption is being diverted for intravenous administration. Some of the compounds in methadone syrup can have adverse effects when administered intravenously, particularly sorbitol and its metabolites. Intravenous sorbitol administration can result in minor adverse conditions and potential life-threatening events such as lactic acidosis. In the current study, 365 subjects were recruited by means of a "snowballing" method and interviewed. The questionnaire elicited information on demographic characteristics; drug-use history, including questions about injecting methadone syrup; current treatment involvement; level of heroin dependence; use of preventive measures against heroin overdose; and risk behaviors associated with heroin overdose. Level of heroin dependence was assessed by the Severity of Dependence Scale, measured on a 0-15 point scale. Of the 365 subjects, 18.4 percent reported having ever injected methadone syrup, and 11 percent had injected methadone in the last 6 months. Those who had injected methadone were more likely to be male and to be receiving methadone maintenance. They were also maintained on higher doses of methadone than subjects who did not inject methadone. A history of methadone injection was associated with more heroin overdose experiences and greater dependence on heroin. Methadone injectors were also more likely to engage in risky behaviors associated with heroin overdose, including using heroin when no other people were present, not trial-testing new batches of heroin, and polydrug use. 1 table and 29 references