So another child is dead due to methadone overdose. It isn’t a rare occurrence; there is some every year and I have just seen another report. Collateral damage, I have heard it called, but it is the sad and needless loss of a life. Misadventure, the coroner often calls it, unfortunate, inadvertent, but quite predictable – and that is the sad thing.
So what was it this time? Parents who dip the dummy into the methadone to help the child sleep? A parent who leaves the dose of methadone in a cup on the table? Older children who mimic mummy/daddy when she/he leaves the methadone safe open? A teenage methadone party? It doesn’t really matter does it?
We are talking about a child born into a family struggling with addiction. Often a child that is neglected, with one parent that is ‘away’ somewhere for some of the time. A family that is slightly flaky – or should we call them ‘troubled’ to be accurate, with some undesirable friends and contacts and not living in the best accomodation. It is hard enough for the child and it is hard enough for the parents.
So what do we do – we offer the parent methadone as part of their detoxification program. The reason – probably it is because it is cheap and can easily be administered under supervision 6 days a week. The parent might actually ask for it – always a good choice if you want to top it up or trade it. And the supervision cost is less – although the whole process of supervised administration does not fit well with a parent trying to pull their life together and look after a child. Ask any mother how long it can take to get your baby ready to go out in the morning.
We know that methadone is extremely dangerous to children. Perhaps that explains why the dose is so often a little on the low side. Perhaps we invest the savings in special methadone safes. We could always supply naloxone injections and train the parents how to use them should their children ‘inadvertently’ take an overdose on the end of their dummy. We could add on the label – do not even think of dipping the dummy in this solution.
Or perhaps we could use buprenorphine.
Nah – that would cost us more. Hmmm – it is generic now and on category M. Yes, but it takes longer to supervise.
But it is much less likely to kill a child.
If you haven’t spotted the hidden statement – here is this. Do not use methadone within your detoxification regimen if the patient is living in a home where children reside or are likely to visit.