We received reports from Scotland about diversion of methadone in pharmacy distribution and it led to several considerations by their parliaments about ending access to methadone treatment entirely. This challenge to continue providing access to methadone maintenance to treat opioid use disorder in these countries motivated the World Federation for the Treatment of Opioid Dependence to write a letter to the Scottish Parliament and members of the Irish Parliament to forestall such legislative considerations.
It is also important to reference an article by Graham Gauthier, Joseph K. Eibl and David C. Marsh, published in Alcohol and Drug Dependence during 2018, “Improved Treatment-Retention for Patients Receiving Methadone Dosing within the Clinic Providing Physician and Other Health Services (Onsite) Versus Dosing at Community (Offsite) Pharmacies”. This original research included 3743 patients, and compared methadone dispensed through a clinic to methadone prescriptions through a pharmacy.
“The findings of this study suggest that patients receiving methadone dosing within the MMT clinic have an increased likelihood of being retained in care as compared to patients choosing to obtain observed dosing in a community pharmacy. We advocate that both the physician and patient should be aware that in-clinic methadone dosing correlate with improved treatment retention.” [11]
At the present time, we do not recommend the use of pharmacies dispensing methadone hydrochloride products through physician prescribing.
