Given that many users inject their drugs, this raises the alarming prospect of the spread of AIDS and other infections. Therefore, we support the Committee's recommendation for the expansion of methadone services. However, we would also like to register some reservations about current programmes and suggest that modifications be investigated and considered. There are serious limitations to current methadone programmes. Methadone is regarded by many as being more addictive than heroin, and it is also regarded as inadequate for keeping clients away from heroin, particularly in the early stages of intervention.
Clients frequently return to the injection of black market opiates.
There are also concerns that traditional methadone programmes are sometimes demotivating, coercive or unrealistic in their demands. To address these problems, certain modifications to current methadone programming should be considered. First, consideration should be given to providing for safe drug and needle use in situations where methadone users may be taking drugs outside of the programme. Consideration should also be given to the provision of drugs other than methadone and non-injectable drug options such as smokable preparations. We recommend that alternatives such as the Merseyside programme in England, where methadone and other drugs are available through physicians, be examined to see if certain elements of these programmes merit consideration in Ontario.