In fact, until last month, the package insert for methadone included a potentially fatal �usual adult dose� for pain patients � up to 80 milligrams a day.

Last month, the FDA issued a public health advisory for methadone, titled �Methadone Use for Pain Control May Result in Death.�

The agency also revised the drug�s package insert, cutting the recommended maximum dose to 30 milligrams a day for new pain patients.

The media often portray methadone overdose victims as drug addicts and criminals who steal it or buy it illegally off the street. But a significant number of victims were prescribed the drug to treat their pain, according to a Gazette-Mail investigation.

The new study provides evidence that many methadone victims are older people, not the stereotypical younger drug addict. People between the ages of 35 and 54 were the most likely to die of a methadone overdose.

The number of people dying because of methadone is now twice the number dying of a heroin overdose and 1,400 less than overdoses blamed on all other narcotic painkillers combined.

West Virginia led the nation in accidental methadone overdose deaths with a rate of more than five deaths per 100,000 people, compared to one death per 100,000 nationwide. That number is based on a Gazette-Mail analysis of raw data provided in the report.

Florida had the largest number of methadone deaths, 400. Other states with a high rate of methadone overdose deaths per capita include Maine, Washington, Oklahoma, Nevada, Kentucky, North Carolina, New Hampshire, and New Mexico.

To read the other stories in this series, log on 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.

A new study reveals that almost 4,000 Americans died of an overdose of the prescription drug methadone in 2004, more than any other prescription narcotic.

Methadone was a factor in the death of 3,849 people that year, almost four times as many as died in drug-related deaths in 1999. It�s an increase of almost 900 deaths from the previous year.

Methadone was responsible for more deaths than any single prescription painkiller listed in the report, including oxycodone, fentanyl, morphine and hydrocodone.

At least four out of five of these deaths were ruled accidental by medical examiners.

West Virginia continues to lead the nation in methadone-related deaths per capita, with 99 deaths in 2004. The state also has the fastest growing rate of methadone overdoses.

The study was completed this month by the National Center for Health Statistics, which is part of the federal Centers for Disease Control.

Earlier this year, the NCHS completed an analysis at the Gazette-Mail�s request of methadone overdose deaths. In June, the newspaper was the first media outlet in the nation to report the large increase in deaths tied to the painkiller.

Methadone often is confused with �meth,� or methamphetamine, a stimulant commonly cooked in clandestine labs and sold illegally. Methadone is a completely different � and legal � drug.

Methadone once was given mostly to heroin addicts to ease their cravings for the illegal drug. Now, methadone is being prescribed by more doctors to treat pain. Insurance companies favor it because it is cheap and effective.

However, it also can be uniquely dangerous. 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.

Reactions to methadone vary dramatically. A dose that is therapeutic for one person might kill someone else.

In fact, until last month, the package insert for methadone included a potentially fatal �usual adult dose� for pain patients � up to 80 milligrams a day.

Last month, the FDA issued a public health advisory for methadone, titled �Methadone Use for Pain Control May Result in Death.�

The agency also revised the drug�s package insert, cutting the recommended maximum dose to 30 milligrams a day for new pain patients.

The media often portray methadone overdose victims as drug addicts and criminals who steal it or buy it illegally off the street. But a significant number of victims were prescribed the drug to treat their pain, according to a Gazette-Mail investigation.

The new study provides evidence that many methadone victims are older people, not the stereotypical younger drug addict. People between the ages of 35 and 54 were the most likely to die of a methadone overdose.

The number of people dying because of methadone is now twice the number dying of a heroin overdose and 1,400 less than overdoses blamed on all other narcotic painkillers combined.

West Virginia led the nation in accidental methadone overdose deaths with a rate of more than five deaths per 100,000 people, compared to one death per 100,000 nationwide. That number is based on a Gazette-Mail analysis of raw data provided in the report.

Florida had the largest number of methadone deaths, 400. Other states with a high rate of methadone overdose deaths per capita include Maine, Washington, Oklahoma, Nevada, Kentucky, North Carolina, New Hampshire, and New Mexico.

To read the other stories in this series, log on 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.