Dear Canterbury District Health Board,

I would like to know how many methadone dispensing errors have been reported by pharmacists in the CDHB region in the last 5 years. What was the result of said errors? (did it result in death, overdose etc).

I would also like any information available about, including reasoning and justification for the policy of diluting methadone takeaways in Canterbury as it appears to be a policy unique to Canterbury and not inline with the rest of New Zealand. I would also like to know why this policy overrides the instructions of doctors who request methadone not to be diluted with water.

For the purposes of the Act, I am a New Zealand citizen and residing in New Zealand at the time of making this request. You generally have 20 working days to respond to this notice, as required by law. Your response will be published publicly on the fyi.org.nz website.

Yours faithfully,

Jason

Dear Kathleen Smitheram,

I have a couple of follow up questions in reply to the response provided by Carolyn Gullery.

Does the CDHB / CORS policy of diluting methadone takeaways apply to people who are prescribed methadone by a GP or OST Clinic outside of the CDHB region but have it dispensed from a Christchurch pharmacy? IE If someone is prescribed methadone by an Auckland, Masterton or Wellington GP / OST clinic which does not require dilution, and the Doctor specifies DO NOT DILUTE (or even without this specification), does the dangerous CORS policy of requiring dilution apply or over rule the Doctors wishes if the patient has nothing to do with CORS? Do pharmacists in the CDHB region have to dilute out of region methadone patients takeaways when their GP does not require dilution and perhaps even specifies there should be no dilution?

I think whoever provided the reasoning for dilution of methadone might be a little confused... How does dilution prevent diversion of takeaway doses? IE the takeaway dose is being taken home anyway so there is no need to divert it... Needle exchanges supply 60ml syringes, and most people have stove tops they can use to remove the added water so it seems like nothing is achieved except endangering the patient by preventing them from verifying they have received the correct dose of medication (something that should be a basic human right).

Looking at the provided table regarding the dispensing errors am I right in interpreting "unconfirmed" as meaning the CDHB doesn't know what the outcome of the error was? IE the patient may have overdosed, received Naloxone from an ambulance EMT and then refused admission to hospital so it was not linked to the dispensing error?

It would also be good if you could provide me with copies of any emails, memos, directives, communications etc held by the CDHB relating to the topic of dilution of OST clients methadone doses. Of particular interest would be any communications between anyone from the CDHB / CORS and the National Association of Opioid Treatment Providers regarding the CORS policy of dilution of methadone doses.

Yours sincerely,

Jason