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Jonas W. fears the moment when he will no longer receive methadone.
Carla DeVizziEditor News
Uncertain times have dawned for the 9,000 methadone patients in Switzerland. There is a risk of a supply bottleneck for the methadone drug Ketalgin, which the World Health Organization classifies as vital. The problem: At the end of the year, the approval authority Swissmedic withdrew the license from the largest Swiss methadone tablet manufacturer, Amino AG in the canton of Aargau.
Since then, production has been paralysed. A possible supply bottleneck could have fatal consequences for methadone patients. So also for the heroin addict Jonas W.* (36) from Zurich. He has been on Ketalgin for eight years – the two pink tablets are his daily companion and “life saver”, as he says. Thanks to them, he got off the syringe. When he thinks about the impending methadone deficiency, his throat tightens. “If the methadone runs out, my whole nightmare starts all over again,” he says.
Do I need heroin again?
It all started in the apprenticeship with smoking weed. Jonas W., who lost his father at an early age and was bullied at school, sought the self-confidence he had always lacked in addictive substances. As a result of the wrong handling, he later came into contact with ecstasy, cocaine and finally heroin. “First I smoked it, then in the end I even injected it.” Heroin ruled his life for four years.
Today he is stable thanks to the methadone program and the psychiatric treatment at Arud, the center for addiction medicine in Zurich. “The only question is how long when the methadone is scarce,” he says. In particular, the uncertainty is getting to him – countless questions are buzzing around in his head: “Will I end up back on the street because I can no longer get my preparation? What is the alternative I am then confronted with? Or even: crap, I don’t know anyone who sells heroin anymore. Do I need it again then?”
“Those affected do not tolerate other medications or much worse”
Methadone is an opiate drug (opioid agonist) used to treat people who are addicted to opiates such as heroin. According to the Federal Office of Public Health (FOPH), there has been a legal basis for treatment with methadone in Switzerland since 1975.
Methadone is an opioid whose effect is long-acting – i.e. it is always constant, lasts 24 hours and reliably prevents withdrawal symptoms. According to Thilo Beck, Co-Chief Psychiatric Physician at the Arud Addiction Center, one is in a daze, but by no means. “Patients are also allowed to drive a car or go about their work,” says the doctor to Blick.
If people who have been carefully adjusted to methadone for many years suddenly have to be switched to a drug with a completely different effect, it is a “huge catastrophe with fatal consequences”. “Those affected do not tolerate the other drugs available for the treatment of opiate addiction, or do so much worse.” At Arud, 400 patients are affected.
Methadone is an opiate drug (opioid agonist) used to treat people who are addicted to opiates such as heroin. According to the Federal Office of Public Health (FOPH), there has been a legal basis for treatment with methadone in Switzerland since 1975.
Methadone is an opioid whose effect is long-acting – i.e. it is always constant, lasts 24 hours and reliably prevents withdrawal symptoms. According to Thilo Beck, Co-Chief Psychiatric Physician at the Arud Addiction Center, one is in a daze, but by no means. “Patients are also allowed to drive a car or go about their work,” says the doctor to Blick.
If people who have been carefully adjusted to methadone for many years suddenly have to be switched to a drug with a completely different effect, it is a “huge catastrophe with fatal consequences”. “Those affected do not tolerate the other drugs available for the treatment of opiate addiction, or do so much worse.” At Arud, 400 patients are affected.
The situation is comparable to a person suffering from diabetes who is deprived of insulin. «It doesn’t work without it. If I don’t get my methadone, I can’t live a normal life.” The same goes for all the other people with an opioid addiction who, like him, are on methadone treatment at Arud or other institutions. W. is therefore certain that in the event of a bottleneck, procurement crime will increase enormously: “People will find other ways to get the goods.”
Thilo Beck (61), co-chief physician for psychiatry at Arud, also has this fear. “If their drug is no longer available, the patients will most likely drop out of the treatment and instead look for the substance on the street again,” says the psychiatrist.
The first tablets are already running out in Zurich
Jonas W. no longer wants to go out on the street. In total, he lived “on the street” for two years. Today he has a room in a shared apartment and a job in service: “I’m finally part of society again. I really hope it stays that way.”
If and when the methadone drug will run out is not clear. At Arud, however, the bottleneck is already noticeable: “We are at the end of our stocks, we have already run out of the first tablet strengths. It’s getting tighter.” In two to three weeks they were then completely shot out.
According to Beck, this predicament could have been prevented. “The manufacturing company and Swissmedic have obviously been involved in a year-long process. Nevertheless, we were not informed, »said the psychiatrist, who is also on the board of the Swiss Society for Addiction Medicine. Instead, they were presented with a fait accompli and now it is in the stars how things will continue.
In the meantime, company owner Edmund Wyss has submitted an application to Swissmedic for a new specialist at Amino AG. The Swiss Agency for Therapeutic Products cannot say how long the approval of this procedure will take.
* Name known