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Methadone

AS more people learn the dangers of the powerful painkiller methadone, they are taking important steps to make sure the drug is carefully administered.

Organizers of a continuing education conference for doctors next month have added a methadone expert as a speaker. Conference leaders said they were moved by Sunday Gazette-Mail reports showing that West Virginia has the nation?s highest death rate from methadone.

Meanwhile, a new analysis from the U.S. Centers for Disease Control confirms what other reports have found: that the number of deadly methadone overdoses is rising. The CDC said the overdoses rose 213 percent between 1999 and 2002. The drug is blamed for more than a third of all deaths from opioid drugs. That group of drugs, which includes codeine, oxycodone, hydrocodone, morphine, hydromorphone, fentanyl and meperidine, caused 91 percent more deaths in 2002 than in 1999.

Doctors are writing more prescriptions for these drugs, increasing the chance that some will be involved in a fatality. But in the case of methadone, it is also prescribed differently than in the past, and its sales have increased almost 10 times during the past decade.

The drug was developed in Germany during the 1940s as an alternative to costly and addictive morphine. Years later, doctors discovered that they could wean heroin addicts off that illegal drug by satisfying their cravings with methadone. Methadone has been used mostly to help drug addicts until recent years.

But it is cheap and powerful, and has been increasingly prescribed as a painkiller. As reporters Scott Finn and Tara Tuckwiller documented earlier this summer, the drug often is given to people unaccustomed to taking pain medication. The drug?s federally approved label lists a ?usual adult dosage? high enough to kill some people. The drug lingers a long time in the body, which makes it good for dulling pain over many hours, but this also means it can build up to toxic levels very easily. Patients have died taking the medicine exactly as it was prescribed.

Reversing the trend of death associated with methadone will take efforts by many groups. Federal drug authorities are late in requiring more explicit labeling for consumers. Doctors and pharmacists must make an effort like those at the conference next month to become better adept at prescribing the drug safely. In the meantime, patients, especially those who have little or no experience with powerful drugs, must be wary.


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