��Killer Cure� Series in West Virginia Paper not Helpful,� read the second headline.
�The problem for the treatment field is that each time the overdoses make headlines, many people in the public, including lawmakers, don�t understand the difference between methadone the addiction medication, and methadone the painkiller,� the article says.
Actually, there is no difference in the chemical composition of the two forms of methadone. But methadone clinics in most states are highly regulated and must closely monitor patients, whereas doctors with little training in pain management can prescribe methadone.
In the article, Parrino said too many doctors and pharmacists are ignorant about methadone�s unique properties.
�Unlike with other prescription opioids, the doctors aren�t sufficiently educating the patients. The pharmacists aren�t doing anything. There�s no education,� he said.
Also, the package insert that comes with methadone contains dangerous and potentially deadly language about the �usual adult dosage� of methadone, according to several physicians and pain researchers contacted by the Gazette-Mail. The drug manufacturer writes the language and the U.S. Food and Drug Administration approves it.
�The usual adult dosage is 2.5 mg to 10 mg every three or four hours as necessary,� reads the drug�s package insert under �For Relief of Pain.�
Someone reading that label could believe it is safe for an adult to consume up to 80 milligrams of methadone a day.
But 50 milligrams of methadone or less can kill a patient not used to strong painkillers, studies say.
�Most people would die if they took 80 milligrams a day,� said Lynn Webster, a pain doctor and researcher from Utah. �That�s an extremely dangerous, liberal guideline.�
Last month, Sen. Jay Rockefeller, D-W.Va., and Sen. Chuck Grassley, R-Iowa, called on the FDA to strengthen the warnings to consumers about methadone.
An FDA spokeswoman said the agency was working with the makers of methadone to make appropriate changes to the labeling for methadone painkillers. But one of the largest manufacturers of methadone said the FDA hasn�t talked to them, and the other major manufacturer referred a reporter to the FDA.
The FDA has not responded to a Freedom of Information Act request from the Gazette-Mail asking for information about its effort to change the methadone labeling.
Parrino said the label might need to be changed, but he opposes adding a �black-box warning� or other strong language about overdose risks because it might scare away people who need methadone treatment.
�If this goes unchecked, somewhere along the line some elected official will want a black-box warning,� he said. �But is more harm done than good? It further stigmatizes a medication, a treatment and a disease.
�[The deaths] further stigmatize the treatment system,� Parrino said. He added that during a recent trip to Charleston, someone told him, �We don�t want that devil drug here.�
For the rest of �The Killer Cure� series, go to www.wvgazette.com/section/Series/The Killer Cure
To contact staff writers Scott Finn and Tara Tuckwiller, use e-mail or call 357-4323.