REDUCING THE HARM FROM INJECTING METHADONE

Methadone in Australia comes in syrup form. The active ingredient is methadone hydrochloride. Here are some methadone-specific tips to reduce harm if you’re planning on injecting your dose.

Drew: I’m on bupe at the moment – Subutex, the biscuits instead of the film. One of the things I like about NUAA is that they give out wheel filters. Subutex has cornstarch in it, which makes it harder to inject – it turns into gravy when you mix it with water, so I use wheel filters to fix that up.

Dilute your dose 

Veins don’t like thick sticky syrup! In order to inject methadone syrup, you must dilute it with water. However, injecting a large amount of liquid can damage your veins. A compromise is to go for a 1:1 ratio, adding the same amount of water as methadone. 

You don’t need to dilute Biodone. 

Filter first 

The syrup isn’t produced to be injected and the dispensing machines aren’t sterile – neither are the cups or bottles your dose is dispensed into.  

Using wheel filters will help remove the additives and germs. If you don’t filter, you’re increasing the risk of dirty shots, infections, vein damage and organ failure. 

There are 2 wheel filters, but we recommend the blue for methadone and Biodone. A red wheel filter (1.2 microns) removes larger particles – especially useful for filtering pills, while the finer blue wheel filter (0.22 micron) removes bacteria.  

Using a bacteria wheel filter is particularly important if the methadone you intend to inject has been diverted and did time inside someone's mouth. 

Do not reuse wheel filters. They are not effective second time round. 

 Butterflies and bigger barrels 

When you water down your dose, you’re going to end up with a lot of liquid to inject.  

You will need specialist equipment to avoid the vein damage, discomfort and difficulty that comes with injecting several times in a row. You will need to use a large barrel syringe (10 to 20ml) and a winged infusion set or “butterfly”, especially useful for holding the needle in place if you need to change barrels.  

NSPs in NSW do not provide this equipment (it’s illegal for us to do so), but they are available from chemists or online at a reasonable price. These are single use items that should not be reused or shared. 

Go slow and be gentle 

You need to inject methadone very slowly because there is a lot of liquid. Going slow will reduce the risk of blowing your veins out. People who inject methadone regularly tell us that their veins have deteriorated very quickly since they started, but that injecting very slowly, including having some wait time during the process, really helps. 

Try Biodone 

If you are injecting your doses, see if you can swap to a clinic or pharmacy that dispenses Biodone instead of methadone syrup.  

Biodone is considered to be safer for injection than methadone by harm reduction standards. Whereas Methadone is a thick syrup with many additives, Biodone is a water-based solution. While they have the same active ingredient – methadone hydrochloride, the additives make all the difference (see page x). 

You don’t need to water Biodone down – you can shoot it straight, so you are injecting a smaller amount of liquid. That means less damage to your veins.  

You still need to use a bacteria wheel filter and follow the other harm reduction tips in this article. 

While some people prefer the version with the additives as they feel it holds them longer, Biodone is better for your general health (eg your teeth and bones).