Methadone injecting in Australia:: a tale of two cities

Aims. The injection of methadone syrup designed for oral consumption is potentially associated with increased morbidity and mortality. Previous reports from Sydney, Australia have suggested a high prevalence of methadone injecting by clients in methadone programmes and by heroin users not in methadone treatment. This study sought to estimate the prevalence of methadone injecting by clients in community based methadone programmes in Melbourne, Australia, which operate under different take away policies. Design. The study used a cross-sectional survey of methadone clients using a self-complete questionnaire. Subjects were recruited from randomly selected methadone dispensing pharmacies across Melbourne. Participation was voluntary. Participants. One hundred and sixty-eight methadone clients were recruited to the study. The mean age was 34.2 years; 59% were male. Findings. Two of 168 methadone clients reported having injected methadone within the preceding 6-month period. Conclusions. The lower prevalence of methadone injecting in Melbourne (compared to Sydney) is thought to be due to the less liberal take-away policy, and the mandatory dilution of methadone take-aways to 200 mi of liquid. Implications for methadone rake-away policies and procedures are discussed.