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

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Abstract
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.