The great organization VOCAL, which is led by and represents people who use drugs, people living with HIV and people affected by mass incarceration in New York, has just released a report called "Beyond Methadone: Improving the Health of Patients in Opioid Treatment Programs." The information in the report is relevant well beyond New York - issues related to patient rights, access to harm reduction services, hepatitis care and treatment, policing, and other areas will be familiar to anyone working on opioid substitution therapy anywhere in the world.
So the whole thing is worth a read, but on OPA we'd like to highlight the report's findings related to overdose. Among people interviewed for the report - all current methadone patients - 10% had experienced overdose themselves in the past 2 years, 20% had been with someone who had overdosed, but 70% of them had no overdose education or naloxone access through their methadone program.
This is changing. Not long ago I spoke with some folks from the Beth Israel Medical Center methadone program (New York's largest methadone provider), who had recently started ramping up overdose education and prescribing naloxone. But VOCAL's report is an important reminder that programs need to move, and now.
I think the real problem here is that doctors tend to prescribe methadone and just forget about it. methadone is designed to help with opiod withdrawal until the person's symptoms of withdrawal wear off, not to be given to you as a permanent replacement for your heroin and to sell to other ppl in your spare time. I think if more doctors actually monitored patients as they weened off methadone, a lot of incidences like this one would not be happening. besides, the guy obviously is being prescribed too much if he doesn't need them and is able to sell them to other prisoners. there's actually an article I read recently that said that the average person's symptoms of opiod dependence can begin to diminish within as little 24 hours after diacetylmorphine, heroin has left the blood stream (the article was on http://www.edrugrehab.com if you want to read it)
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