NDARC Technical Report No. 23 (1995)
A sample of 312 heroin users was interviewed regarding the injection of methadone syrup. Methadone syrup injecting was widespread, with 52% of the sample having injected methadone syrup, 29% in the preceding six months. Males and females were equally likely to report having ever injected methadone syrup, and to have done so in the six months preceding interview. Among current methadone injectors, frequent methadone injecting was common, with 40% reporting weekly or more frequent injecting in the preceding six months.
Methadone injecting was more common in western Sydney, both in lifetime prevalence (58% v 45%) and within the preceding six months (36% v 21%). Frequent injecting was also more common in the western suburbs. Recent methadone injecting was more common among respondents currently enrolled in methadone maintenance (34% v 23%). Both area of residence and treatment status were independent predictors of current methadone injecting.
The two most common sources for obtaining methadone for injection were friends/partners or respondents' own prescribed take-away doses. Illicit methadone was considered easy to obtain by 87% of respondents. The average price of methadone was 50c per milligram in the western suburbs and $1 per milligram in other regions of Sydney.
There were clear harms associated with methadone syrup injecting. Current methadone injectors were in poorer general health than other respondents, and had more symptoms related to injecting. A history of methadone injecting was associated with abscesses and infections in injection sites, and having been diagnosed with a venous thrombosis. Those with a history of methadone injecting were also more likely to have overdosed (70% v 52%), with current injectors being more likely to have overdosed in the preceding six months (26% v 14%). Current methadone injectors also showed higher levels of current psychological distress, were more likely to have recently passed on used injecting equipment and to have recently committed criminal acts.
The results of the present study raise questions about ways in which to reduce the harms associated with methadone syrup injecting. Issues that require attention include: policies on the provision of take-away methadone doses; strategies such as diluting methadone syrup to expand the volume of a methadone dose; and education of methadone maintenance clients on the harmful effects of methadone injecting.