The Pharmaceutical Journal
Vol 272 No 7294 p445
10 April 2004

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· Prescription fraud
· Care homes
· Methadone services
· Sugar in medicines
· Modernisation

Letters to the Editor

Methadone services

Beware of requests for sugar-free methadone

From Mr T. P. House, MRPharmS

If any pharmacists consider offering sugar-free methadone to patients they should refer to the excellent article entitled “Providing methadone services — case studies” by Glynnes Newell (PJ, 21 April 2001, p542, PDF (120K)).

The first case study involves a patient who asks for sugar-free methadone in order to stop tooth corrosion. We are told that the pH of both preparations is equally acid and so there is no benefit of a change, and that the artificial sweeteners used may cause diarrhoea.

Of more importance, we are told that sugar-free methadone has to be prescribed, and so substitution is illegal. Further, the motives for the request may be that, since the sugar-free preparation contains no chloroform, it is more injectable.

T. P. House
Haverhill, Suffolk

Ludicrous to compare heroin addicts to tobacco smokers

From Mr P. G. Sheppard, MRPharmS

I have never been a tobacco smoker myself, but to compare heroin addicts to those who are, as Philip Bates does (PJ, 3 April, p414,) is ludicrous, almost to the point of offensiveness.

Has a smoker ever waved a cigarette stub in your face because you have got no NRT patches left? Is nearly all crime in certain areas perpetrated by people desperate for money to buy their next box of Benson & Hedges? I think not.

I suggest that in time, all dispensing of methadone is moved to prescribing clinics where there are doctors on site to remedy errors with prescriptions and where there are no elderly or vulnerable patients to be intimidated. As for needle exchange schemes, from my experience, the frequency with which “patients” requesting new packs actually return any used ones is negligible, which surely renders such schemes largely useless.

Paul Sheppard
Oldbury, West Midlands

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