"Having my methadone cut at Guernsey House"

Many thanks for taking time to write with your opinion. I think the point you have raised is one that many other patients have asked previously.

Unfortunately at the current time there is no way for us to routinely measure the actual amounts of methadone in patient's urine samples, only to record a positive or negative result. As such when patients miss doses of medication from the pharmacy we often have no option other than to reduce the dose of medication to ensure that any loss of tolerance to the medication does not have a dangerous effect on the patient taking it.

Although this can seem frustrating and laborious, it is the safest way to prescribe opiate medication eg methadone, which has serious side effects in overdose.

Supervision of medication by a pharmacist can be very helpful in observing tolerance and side effects to medication for individual patients and is often reintroduced or increased at times of medication change.

Whilst I understand the reasons in the instance for taking another patient's medication, we would never advise to do this because of safety risks, as well as another person then having a shortfall of their own medication.

When increasing methadone there is a minimum of five days stabilisation between each dose change. As you noted, we always try to review patients quickly with regard to increasing their dose again to try and achieve stability as quickly as possible but have to do this as safely as possible, which is why it sometimes takes longer that patients may hope.

I hope this is helpful. If you wish to discuss this further please mention it at your next appointment.

Dr Gaynor Radley,

Clinical Director,

PCASS