The Pharmaceutical Journal
Vol 278 No 7435 p73
20 January 2007

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• Adverse drug events
• Patient data
• Methadone
• The Society (5)

Letters to the Editor

Methadone

Where do I store individual bottles?

From Mr R. I. Dunkley, MRPharmS

As I read Jenny Keen’s letter in The Journal of 16 December 2006 (p735), I became more and more anguished about the consequences of her point of view. I fully agree with everything she says: “Supplying methadone in large undivided quantities is likely to predispose overdose, both by faulty measurement and through heroin use when the supply runs out early. Many patients admit to simply swigging from larger bottles.”

When supplying methadone for patients who do not pick up their medicine daily, then I fully agree with Dr Keen that it should be supplied in individual bottles, so that the patient has the right dose every day and there is no shortage. However, the purpose of my letter is one of supply logistics. I have some 40 or more patients on methadone. Most are supervised daily but we have about a dozen who collect a week’s supply in one go. I put their supply into individual bottles and away they go. But — as the number of patients on methadone rises and since we should, says Dr Keen, supply in individual bottles — where are we to store the bottles awaiting collection in the meantime? The Controlled Drugs regulations state that CDs have to be kept locked in an approved cabinet or other locked storage approved by the police. The Home Office-approved CD cabinet is hardly big enough to store the methadone stock, let alone the methadone awaiting collection and any other CDs.

In a “normal” week, I can just about store methadone that awaits collection but what happens when patients collect to cover breaks such as bank holidays and I must prepare more? When I have dispensed the methadone bottles, where do I store them so that they are secure?

Bob Dunkley
Dewsbury, West Yorkshire

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