Patients in methadone maintenance treatment who inject methadone syrup: a preliminary study

An increased awareness of the injection of methadone syrup has been appreciated by methadone treatment clinicians and Needle Exchange outlets which distribute large-volume syringes. This study aimed to identify patterns of use by methadone injectors, and the reasons and perceived risks of this behaviour. Nineteen of 36 attendees at a needle exchange who stated they had injected methadone over the previous 3 months completed a structured interview. Results found a majority were methadone clinic patients. Forty-two percent injected three times a week or more. This practice continued in 58%, despite reported difficult venous access. Subjects' concerns included accelerating vein damage and possible toxicity of syrup additives. Reasons for injecting included immediate drug effect (80%) and 'needle-fixation' (47%). It is concluded that methadone clinic staff need to be aware of such patients who may require additional treatment approaches, and that methadone formulations should minimize harmful consequences if injected.