Wednesday, June 22, 2011

Methadone Urine Testing and Diversion

The urine testing done at the Methadone clinic is not just to assess abuse of street substances  while on methadone. It's principal purpose is to confirm methadone in the urine. A doctor takes an oath to do no harm. If there is no methadone in the urine of a patient on methadone then that suggests that the methadone is being diverted. Because methadone has a safe 'window' another person may take methadone and have respiratory failure at a dosage which might well be safe for another.  People who have not developped tolerance to opiates have died at as low as 50 mg dosage of methadone.
Each person's dose of methadone is arrived at by individual titration of the dose and consideration of individual metabolism. If the urine doesn't show methadone the suspicion is the urine is being taken and possibly spit out or saved some other way for 'diversion' and sale.  Earlier this year a person died taking methadone that was 'diverted'.  Some poor doctor who was working in a methadone clinic having taken an oath to do no harm was left feeling complicit somehow in the death of this poor fellow.  Obviously the person who diverted the methadone and then made it available to this person was doing a 'criminal' thing.  Methadone treatment is for sick people with a disease of addiction. If a person 'diverts' methadone they are doing a criminal, not a sick, "thing".  For these reason the methadone patients are urine tested.  If a person is taking methadone then the methadone shows in the urine and confirms that the person is compliant with the treatment program. Further there is no increased risk to others by having the methadone program which is a good thing for community.

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