West Virginia�s death rate from the prescription drug methadone is the nation�s highest. Next month, doctors from across the state will attend an education session to learn more about the drug, and how to prescribe it more safely.
An investigation published by the Sunday Gazette-Mail in June �led us to include a methadone expert at our conference this year,� said Nikki Williams, coordinator of the 10th annual Mountain Retreat Continuing Education Conference.
The investigation found that methadone is involved in the deaths of more people nationwide than any other prescription narcotic. Some of those victims took their methadone exactly as their doctors prescribed it for pain, and it killed them anyway.
Methadone behaves differently from other painkillers, said Chris Terpening, assistant professor in West Virginia University�s Department of Clinical Pharmacy, who will speak at the conference. The same unique properties that make it a good painkiller also can make it deadly.
But the doctors prescribing it don�t always know that. Terpening and Michael Johnson, an assistant professor of family medicine, recently co-authored a journal article on that topic after Johnson saw methadone being prescribed frequently to nursing home and hospice patients.
The Sunday Gazette-Mail investigation found �fairly obvious errors in how [methadone] was being used,� Terpening said.
Also, it found that the package insert that comes with methadone contains potentially deadly language about the �usual adult dosage,� 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,� the package insert states.
But 10 milligrams is a dangerous dose for patients who aren�t accustomed to opioid painkillers, Terpening said.
In his article to be published in the West Virginia Medical Journal, �I�m fairly clear,� Terpening said. �If, on those odd occasions you�re going to use it [on an opioid-naive patient], you�ll probably want to start at 2.5 milligrams initially � and that�s pretty much it.�