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Coroner cautions on methadone

The Age

Monday February 21, 2011

By ADRIAN LOWE COURT REPORTER

VICTORIA'S supervision of recovering heroin addicts administering methadone is "extremely dangerous" and "fraught with risk", a coroner has found, because the way "takeaway" doses are stored is not checked.Methadone used as a substitute for heroin and regarded by the Australian Drug Foundation as an effective way for users to curb their addiction can be prescribed only by approved medical practitioners.Once addicts have demonstrated treatment stability for at least two months and are trying to normalise their lives, among other criteria, the practitioners approve doses to be taken away to be self-administered.But coroner Kim Parkinson has recommended that takeaway doses be banned unless authorities are satisfied they can be safely stored.She has also suggested that authorities need to establish a clear mechanism of supervising addicts' storage of methadone.Ms Parkinson made the comments in her recent finding into the death of Melissa Irwin in December 2009, who died of methadone toxicity after taking her cousin's methadone.Police found a note next to Ms Irwin's body that said she had taken the methadone because she had no money to buy alcohol.Ms Irwin had depression, but Ms Parkinson noted that she appeared to be "relatively stable in mood" before her death and that "there were no indications . . . Ms Irwin had intended to take her own life".The inquest was told that Ms Irwin's cousin had left a bottle containing 110 milligrams of methadone on his bedside table. He was taking five doses each week.The relevant Victorian policy says takeaway doses "must be stored according to the regulations, in a metal cabinet or safe", and advises users to "keep the containers in use in a secure location and return them to the cabinet when no longer in use".But Ms Parkinson said there was little effective supervision of how takeaway methadone was stored, and guidelines did not specifically identify who was responsible for supervising its safe storage or how safety was ensured before takeaway doses were approved."To leave the decision-making and storage arrangements solely in the hands of the addicted person seems to be an approach which is fraught with risk, given the unreliability often associated with persons suffering with substance addiction," the coroner said."That lack of supervision and lack of regulation of the storage arrangements is, in my view, an extremely dangerous practice, which has the potential to result in the death of persons other than the patient and, in particular, children."The Department of Human Services said the state government was in "ongoing discussions with the Coroners Prevention Unit in relation to the specific recommendations of this matter".A spokesman said that when prescribers assessed patients for suitability for takeaway doses, an important criteria was that the patient be living in stable accommodation and have a locked or secure cupboard for storing medication.

© 2011 The Age

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