On Memorial Day weekend in 2004, a traveling fair came to the small town of Oconto Falls, Wis. Sixteen-year-old Josh Engebregtsen and three of his friends decided to go.
His mother, Sue, remembers the night. Everything seemed so normal. Her son called before his 9 p.m. curfew, asked if he could stay at his friend�s house. The boys went home, sat up talking until 3 a.m.
Engebregtsen died in his sleep that night.
During the boys� night of fun at the fair, another local teen offered them some pills. It was methadone that his mother was prescribed for pain. Engebregtsen took two.
The number of people like Engebregtsen that methadone has helped to kill has multiplied � from 790 in 1999 to 2,992 in 2003, according to an analysis of death certificates conducted by the Centers for Disease Control and Prevention�s National Center for Health Statistics for the Charleston Gazette.
Some government officials are responding. Thousands of miles apart, they have developed the same solutions � keep track of who is being prescribed methadone and who is dying from it, and educate doctors, pharmacists and patients about the drug�s dangers.
Two 10-milligram pills
Catherine Sanford, a North Carolina epidemiologist, watched the number of deaths caused by methadone in her state rise from seven in 1997 to 248 in 2004.
�It was shocking,� she said in a telephone interview. �We couldn�t believe what we were seeing.�
In 2002, Sanford went to her boss, Carmen Hooker Odom, secretary of the North Carolina Department of Health and Human Services. Odom called together a task force of state experts to develop a plan.
Something similar happened on the national level in 2003, when the federal government convened a conference about methadone overdose deaths. But few of the conference�s recommendations have been implemented, experts who were involved in the conference told the Gazette.
In North Carolina, officials set up a special �working group� to make sure their plan was implemented. Every three months, representatives from law enforcement, public health, doctors and pharmacist groups met to figure out which goals were being met and which were not.
Since then, the state Legislature passed a law to create a statewide database to keep track of potentially addictive and easily abused prescription drugs such as methadone.
The database is designed to stop �doctor shoppers� � patients who go from doctor to doctor, piling up multiple prescriptions for the same drug.
Pharmacists and doctors are being asked to tell their patients to keep the drug in a lockbox or other safe place.
�We�re not trying to demonize methadone. But if we don�t make it safe to use these drugs, they might be taken away. We don�t want that to happen,� Sanford said.
Sanford closely tracks methadone overdose deaths in her state. Because of the state�s surveillance system, she noticed when more and more teenagers began dying from methadone.
In response, the state is developing an educational campaign on the dangers of prescription drugs, especially methadone.
Teenagers are being told in explicit language that taking methadone to get high, even in small doses, can be deadly.
��One pill can kill� is one of our slogans,� Sanford said.
Or two pills, in Josh Engebregtsen�s case � two 10-milligram pills.
Sue Engebregtsen had never heard of methadone before her son�s death. She had to research it on the Internet.
�It�s just so scary, because it is a tiny little white pill,� she told the Gazette. �Think about two aspirin � that�s 500 milligrams. You look at that tiny little pill that says �10� on the top and think, �How dangerous can that be?� From a kid�s perspective � or an adult.�
Even the local newspaper assumed he must have downed the pills with alcohol, she said.
�The papers here said he had been partying and drinking,� she said. �But the toxicology reports showed nothing but the methadone.�
Not in our family