Ten years ago in West Virginia, almost no one died from a methadone overdose, said James Kraner, toxicologist for the state medical examiner�s office. In the first 10 months of 2005, methadone was listed as a cause of death for 97 West Virginians.
In Reno, Nev., Coroner Vernon McCarty said he has seen a fourfold increase in methadone deaths in the last three years.
�There�s too many methadone deaths to keep track of,� McCarty said. �I�ve given up trying to count them all. You ask any medical examiner in the state � he�ll tell you the same thing.�
Not just drug addicts
Here�s the stereotypical scenario of a methadone death: A young man wants to get high. He buys methadone illegally from a street dealer or he steals it from a relative who is taking it for pain. He takes the methadone pills with a toxic combination of other painkillers and alcohol. He passes out, stops breathing and dies.
Most methadone overdose victims had more than one drug in their system at the time of their deaths, according to studies in West Virginia, Maine, North Carolina and Utah.
In 2004, a combination of methadone and cocaine killed 17-year-old Brandi Bragg, granddaughter of West Virginia�s biggest lottery winner, Jack Whittaker. She did not have a prescription for methadone, according to her death certificate.
But in West Virginia, one in five methadone overdose victims had no other drug in their system, according to a Gazette-Mail analysis of state toxicology and vital statistics data.
Others victims had trace, usually harmless amounts of alcohol or acetaminophen.
Sometimes, methadone victims were prescribed the drug for pain. Sometimes they accidentally took too much. Sometimes their doctors unintentionally prescribed a lethal dose.
A new study says almost half of methadone overdose victims in Utah were prescribed the drug for pain.
Of the 114 Utah residents who died in 2004 from methadone, at least 48 of them had a valid prescription to use the drug, according to the report provided to the Gazette-Mail. More than two-thirds of them died within the first four days of starting their prescriptions, said Christy Porucznik, a Utah epidemiologist.
Only two were using methadone as part of a drug treatment program.
Other states that have studied the problem have discovered similar trends. People with valid prescriptions for methadone made up at least 37 percent of methadone overdose deaths in North Carolina and one-quarter of such deaths in Las Vegas, according to recent studies provided to the Gazette-Mail.
Sometimes, doctors prescribe methadone with other drugs that in combination are potentially lethal.
Vince Verdecchio also was prescribed diazepam for anxiety. His wife found out later that benzodiazepines such as diazepam (commonly known as Valium) increase the risk of overdose when combined with opioids such as methadone.
�To me, it should have been a red flag for his doctor,� she said.
Often, patients make the fatal mistake. They fail to follow their doctors� advice and take more of the drug than prescribed, or they take it with other drugs.
Other painkillers are more forgiving. Make a mistake with methadone and the results are often deadly, Porucznik said.
�With methadone, you can�t just take extra pills,� she said. �You could die.�
Not on FDA�s radar screen
Across the country, some medical examiners and health researchers told the Gazette-Mail they have tried to alert federal officials and the media about the dangers of methadone. But brand-name drugs like OxyContin have received more attention.
Bruce Goldberger is director of the Forensic Toxicology Laboratory at the University of Florida. He has published several studies about methadone overdose deaths in his state.
Goldberger said in a telephone interview that he has tried for years to get the FDA and other federal agencies to pay attention to methadone deaths with little success.
�What does it take to reach the FDA�s radar screen?� Goldberger asked. �Clearly, there has been a huge increase in methadone-related deaths, and they have done nothing.�
FDA officials have increased the warnings on one type of methadone � the type given intravenously to patients in the hospital. But an agency spokeswoman told the Gazette-Mail they were reluctant to put similar warnings on the pill form given to most pain patients, because it could scare off potential drug treatment patients.
�The mortality rate associated with untreated opioid addiction is extremely high and the effect of placing a �boxed warning� regarding the potential cardiotoxicity was determined to have a potentially negative impact on appropriate treatment of these patients,� FDA spokeswoman Suzan Cruzan said in an e-mail.
The FDA is now working with methadone manufacturers to �make appropriate changes� to the pain-pill labels, she said.
Marianne Verdecchio said patients need stronger warnings about methadone�s risks.
�I think people need to be educated,� she said. �I don�t think they should have to go online and educate themselves. The doctor needs to say, �You really need to be careful with this medication, because it�s really strong.�
�I think they should try really, really low dosages and see how a person reacts before they even write a prescription for it.�
The Verdecchios had two children, a son, 25, and a daughter, 23.
�We had just had our 25th anniversary,� Marianne Verdecchio said. �I shouldn�t be a widow at 46.�
To contact staff writers Scott Finn or Tara Tuckwiller, call 357-4323 or 348-5189.
What is methadone?
What it is: Methadone is a synthetic opiate developed by the Germans during World War II as a substitute for morphine.
What it isn�t: Methadone often is confused with �meth,� or methamphetamine, an illegal stimulant commonly cooked in clandestine labs. Methadone is a completely different � and legal � drug.
Uses: Until recently, methadone was given mostly to heroin addicts to suppress their cravings. Now, doctors are increasingly prescribing it as a painkiller.
Dangers: Methadone acts differently from other painkillers. It can stay in the body for an unusually long time, making it possible for therapeutic doses to build up to a toxic level.
Methadone may take a while to make its effects felt. Patients may take an extra dose, thinking the first one isn�t working, and an overdose can result.
An overdose of methadone may cause a patient to fall into a deep sleep and eventually stop breathing. Methadone is more dangerous when taken with certain other drugs, such as Valium and Xanax.
Reactions to methadone vary dramatically. A dose that is therapeutic for one person might kill someone else.