For the last couple of weeks, Vernon, B.C., pharmacist Jodi Cunningham has been working to make sure the impact of the Metadol-D shortage is minimized for her patients.
Metadol-D is a popular brand of methadone, a medication that is used to help people with opioid withdrawal so they can stop taking toxic street drugs.
“We did try to get ahead of it a little bit and make sure we had extra on hand. We tried to source from multiple suppliers,” said Cunningham.
The pharmacy also asked a few patients to switch to a different formulation of methadone which, Cunningham explained, is not without risk.
“There is always a risk of destabilization when patients are switched formulations. Theoretically, all of the methadone formulations should work the same because they are the same drug in the same concentration. Clinically we have seen differences, however, where some people respond better to one formulation than another,” said Cunningham.
“Some find a certain formulation, for example Metadol-D might control their withdrawal symptoms better or for a longer period of time therefore they are at less risk of going to an illicit supply.”
Cunningham said by being proactive, at her pharmacy, the shortage hasn’t caused any significant destabilization for patients.
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The pharmacist said if people are finding they are not getting the same effect with an alternative, the pharmacy will keep some stock of their preferred product aside for them.
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Last week, the BC Association of People on Opiate Maintence put out a statement pointing out that given the current toxic drug crisis, withdrawal can be deadly.
“These shortages have happened too many times before and will happen again. This doesn’t just need to be fixed once, the government needs to take charge and fix this for good,” the statement said.
Cunningham believes increased demand for opioid treatment may have contributed to the shortage.
“There really has been a shift right now where people are accessing treatment because of the toxic drug supply and the absolute crisis that we are in right now. It is just a matter of demand and then manufacturers and suppliers increasing their capacity to handle that demand,” she said.
The province said the Metadol-D shortage was officially resolved in mid-March, but admits that the initial issue “is still causing intermittent availability at the wholesale level on all oral methadone products.”
The province expects the methadone supply in B.C. to normalize “shortly.”
Cunningham is expecting the supply available for her pharmacy will return to normal within a few weeks.
The pharmacist praised the provincial Pharmacare program’s work to address the shortage. Cunningham said BC Pharmacare quickly added additional formulations of methadone to the list of drugs it will pay for.
In a statement, the Ministry of Mental Health and Addictions said the province “recognizes the importance of these products and that the lack of availability can cause destabilization for patients on methadone treatment,” and is “working collaboratively with manufacturers of oral methadone products to address the current supply issue and avoid further supply disruption.”
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