Another Toddler dies, Time to cut out the Sugar?

[Alan J]

Dear All,

Yet again we read about the sad death of a young child due to ingestion of methadone. I am sure we would all wish to give our condolences to the parents, family and all who loved & cared for the little one.

Although we do not know the facts that led to this childs death it is important that we ask questions that each toddlers death present us with.

One question I would like to ask is why do we still get prescribed, as standard, oral methadone solution in it's sweetened form. Perhaps it is time that the continued use of the standard 1mg/1ml methadone oral solution formulation, which is extremely sweet, be reviewed especially in enviroments where toddlers are around?
There is a direct alternative , eg, the sugar free format, which would at least be far less palatable to a childs tastes.

While this in no way absolves parents from their responsibility's and duty of care
especially when it comes to safe storage of not only methadone but all potential harmful medications (including paracetomol) out of not only childrens but other adults reach. But to askif there are practicable, easy, methods of reducing the direct risk of harm in the short term?

While relying on a bitter tasting methadone formulation will not offer a total eliination of risk it would provide an additional approach to managing it.

Currently, the main objection to prescribing sugar free oral solution 1mg/1ml
appears to be the fear of an increased risk of it's being used IV. While I acknowlege that there is a very small number of users who are foolish enough to pursue this
high risk and harmful practice, the veinous damage can be substantial, this remains a small and hidden problem. One could argue that these individuals should not be on an oral script in the first place which then leads one to question why these individuals feel unable to ask or seek a form of methadone (eg amps) or diamorphine that would better meet their needs and reduce the risk of harm at the same time?

In addition, why cannot a cheap lockable container for methadone and other med's be developed? It could be based on a sharps bin with a cheap padlock or other locking device and issued to parents free or for a small charge? Production and development costs need not be that high and the potential for wider sales to other patient groups could help offset costs?

A very sad death, how can the risk of further deaths of this kind can be reduced in the future ?

[bp]

Hi ALan

I'm afraid that a lockable box isn't the answer for people who are basically negligent about storing methadone whether or not children are involved. If they can't be bothered putting it in a safe place then I doubt if they'll be bothered to use a box with a lock, perhaps it will be used for the first few days but after that the bottle will just go on the shelf again. I'm very angry about this whole story, another child has died, supervised consumption will now be imposed with a vengence and just because people couldn't be bothered to put their medication in a safe place; it's the same old same old.

Beryl

[Jim]

this reminds me of a consultation day I once went to for a drug company (in my annual leave I hasten to add- but they paid very well).  they were developing a methadone dispensing canister which dlivered a specified daily amount of methadone sprayed into the mouth, operated by finger print.  It was micro chip technlogy.  We felt at the time it would not be enough for them to claim that this could be used instead of supervision to avoid diversion as the police would claim that you could sell it on by putting you fingerprint in a spraying it into someone elses mouth.  However, it would be a pretty foolproof way of preventing this death in east Lothian.  It may also be preferable to a response of putting everyone back on supervised consumption.   We pretty much gave it the thumbs down on the day but it we didn't really consider this scenario.

[Tony.B.]

All

My heart and solar plexus just reeled reading this as it came into my inbox.

Obviously all our thoghts are and should be with that poor unfortunate family, what an absolute nightmare for anyone to have to endure.

My heart does go out to them.Also on a more selfish note quoting Annabel Goldie, leader Scottish Tories,

To Ministers..'we have to stop parking Addicts on Methadone'

Terrible time for family, with possible ramifications for all, especially as Scotland seems to be a hotbed of an Anti user campaign fuelled by irresponsible media.

My Prayers go out to this Family
Tony.B.

[simon]

It is always sad to hear of such things and always tell my patients to keep there methadone/subutex away from little people and animals. I remember when I worked in the prison service a couple of prisoners who were there due to the above circumstances.
I remember as a child chewing the top off the child proof junior aspirin because they used to taste so nice. I think lockable cabinets may work for some if it only saves one life, but then what cabinet do you lock the key into ?.

[bp]

  However, it would be a pretty foolproof way of preventing this death in east Lothian.  It may also be preferable to a response of putting everyone back on supervised consumption.   We pretty much gave it the thumbs down on the day but it we didn't really consider this scenario.

Apparently 97% of people on methadone scripts in Scotland are on supervised consumption, how on earth are any of them meant to achieve a normal life? One of the main pros of methadone prescribing is to enable people to achieve "stability" but how does one even begin to look for a job if on supervised consumption. Sadly, as long as stories such as this are used by the media to crucify users we haven't got a chance, but if it was aspirin or bleach it probably wouldn't even be in the local paper.

I feel that the public, or a large percentage of it, perceive methadone in the same way as they do heroin, it's a drug, it's evil and the people who use it are evil.

Beryl

[daveywales]

Yes Alan why don't they make the methadone taste bloody vile. I don't care if it is going to save kids lifes. It is alright blaming the parents but having kids I can see how easy it is for a kid to climb on a stool, then up on the kitchen unit, open the cubord door. Or the same kind of scenareo in the bedroom, I don't have the facts to see whether I blame the parents-leaving a bottle on a table is different from storing it in a high cuboard your kid can't(or you think) reach. I feel their pain compounded by guilt.
Can't see this affecting supervised consumption as the service providers know they will loose people out of treatment if they do a blanket SC, which will harm far more children in the long run with their parents back on buying street gear.
Yes Alan make it all sugar free and add somthing horrible to it, and if the punters moan about the taste, tuff, think of children and make it know why the taste has changed. For those on high scripts I think they should be given the oppourtunity of concentrate. David

[Rokki]

Do ya think it's time for dry meds there or what??? Let not make the patient suffer cuz someone is an idiot. We are not all idiots,quiet as it's kept. Nor should we have to carry locked boxes cuz we are so stupid we don't know how to take our meds properly. No,you won't hear about the kid who dies cuz they drank bleach..Lets focus on the "M" word,it already has a lot of stigma attached to it... Plus the media will eat it up and we can make lots of money selling papers and online subscriptions. Yeah,lets make an expamle out of this error....OH GIVE ME A BREAK!!!!!!

   Yes,no one should have to bury their babies and I'm very sorry this has happened. But did the paper also print a story showing how good this medication is? Of Course Not! Lets feed the stigma and propaganda and hysteria...<rolling eyes>

  I'm with You Beryl 

L&R

Rokki

[Tony.B.]

Morning

Spot on Rokki.

Really good to begin to  get to know you a little from your posts+mutual friends.

Beryl interesting i talked to a consultant, who i respect, she was telling me about when at Maudsleyspelling? London they had  exactly the same scenario and the boxes reigned at the end of the day.

I approached This lady and the clinical board asking for assurances that there would be no 'Knee-jerk' reactions and s.com isn't used as a tool to appease media+jo.P.

That was reply i got.So it did work, does work, if only to stop dead in it's tracks this train heading to a wreck, me probably.

I think we are all kind of right here tho Rokki your post on this is right on the mark.

L+L

Tony

[Rokki]

Thanks Tony for the kind words. I know I am preaching to the choir when I come here and I do get a bit strong sometimes in my words. Thats only cuz my passion is so strong for my beliefs and how I feel we should be treated as Human beings 1st and not put into little boxes. Like putting someone in an "Addict" box...That person is so much more then that awful word. They are warm blooded,with a heart and feelings and should be treated as such firstmost. If we allow someone to put us in a box we are giving up our values and beliefs. I am so much more then a Methadone patient,yet if I was to walk out of the house right now and get hit by a truck and die I would be classified as a methadone death...Not someone who is warm blooded,passionate,cares for others,but a Box all neat and tidy for others to put me in by one single term of words.

Thanks Again,Tony

Love and Respect

Rokki