It should be noted here that the "methadone" used in South Africa at the time of this survey was almost exclusively physeptone
linctus, a much weaker methadone preparation that is currently seldom used in the treatment of dependence internationally.
Full agonist: Methadone (9) (only available as Physeptone
syrup (2 mg/5 ml) in South Africa; opioid detoxification is an off-label use); other--including codeine, morphine-SR, and the atypical opioid, tramadol (none of these medications are registered for detoxification, nor are they widely researched or accepted as medication of choice for detoxification).
It is believed the deaths were caused by a batch of heroin from Afghanistan infected with cow dung or poisoned physeptone
, a morphine-based substitute prescribed to addicts.
Indeed, a detailed analysis is needed in relation to the uses and abuses of physeptone
(the generic name for methadone), naltrexone and other legal heroin-substitution drugs.
The DecisionBase 2011 report entitled Opioid Addiction: New Entrants Offering Even Incremental Improvements in Efficacy Could See Considerable Use in This Difficult-to-Treat Population, finds that, in sharp contrast to surveyed psychiatrists, the largest percentage of surveyed pharmacy directors, just over one half, identified methadone (Roxane's Dolophine, Mallinckrodt's Methadose, Rosemont Pharmaceuticals' Methadose/Metharose, Molteni Farmaceutici/Dee Pharmaceuticals' Eptadone, Sandoz's Methaddict, Cardinal Health's Physeptone
, Esteve's Metasedin, generics) as the most efficacious therapy for opioid addiction.