Sept. 30, 2009 — Methadone deaths have risen sevenfold in less than a
decade, according to a government report that largely blames the increase on
the growing use of methadone for pain relief.

Used primarily for the management of heroin addiction until the late 1990s,
methadone has become one of the most widely prescribed opioid painkillers, with
4 million prescriptions written for pain relief in 2006 alone.
It has also become one of the most deadly drugs around, the report from the
CDC’s National Center for Health Statistics (NCHS) confirms.
The report highlights the rising death rate associated with the use of
opioid painkillers such as methadone, morphine, OxyContin, Dilaudid, and
Vicodin.
Between 1999 and 2006, according to the report:

• Deaths from the use of opioid pain relievers more than tripled in the U.S.,
  from 4,000 in 1999 to 13,800 in 2006. 
• 40% of all poisoning deaths in 2006 in the U.S. involved opioid
  painkillers. 
• The number of poisoning deaths involving methadone increased from 790 to
  5,420 during this period. 
• The opioid death rate was highest for whites, males, and people between the
  ages of 35 and 54.

The Problem With Methadone

The increase in methadone deaths corresponds to the drug’s increased use for
pain relief, which began abruptly in 1999, says Nicholas Reuter, a public
health analyst who has been tracking methadone use and deaths for the Substance
Abuse and Mental Health Services Administration.
Increased concerns about the abuse potential of the pain reliever OxyContin
and the desire for a relatively inexpensive long-acting opioid painkiller led
to the shift in methadone use.
Last year, 750,000 methadone prescriptions were written for pain relief, but
only 250,000 people were treated with the drug for addiction to heroin and
other opioids, Reuter tells WebMD.
Methadone can suppress drug withdrawal symptoms as an addiction treatment
for 24 hours; the drug’s ability to suppress pain lasts just four to eight
hours.
But methadone stays in the system as long as 59 hours. Patients may feel
they need more pain relief before the drug is cleared from the body, and if
taken too often or at doses that are too high, toxic levels can build up, which
can lead to life-threatening changes in breathing and heart function.
”Many of the methadone deaths I hear about involve people who just go to
sleep at night and never wake up,” Reuter says.
 

Deadly Mix: Methadone, Sedatives

In a report released last March examining methadone-related deaths, the
Government Accountability Office concluded that a lack of knowledge about the
“unique pharmacological properties” of the drug among prescribing physicians
and patients has contributed to the problem, as has a rise in methadone’s use
as an illegal street drug.
The newly released NCHS mortality figures were derived from death
certificates, so there was no way to know if the drugs were legally prescribed
or not.
But at least half of the reported opioid-related deaths involved other
drugs, including heroin or cocaine in 15% of cases and benzodiazepines such as
Xanax and Valium in 17% of cases.
“The involvement of benzodiazepines — sedatives used to treat anxiety,
insomnia, and seizures — is particularly troubling as previous studies have
shown that people who were prescribed both methadone and benzodiazepine were at
greater risk of overdose than those prescribed only one of these drugs,” the
report notes.
“We don’t know how the people who died got the drugs they took,” NCHS
epidemiologist Margaret Warner, PhD, tells WebMD. “Federal agencies, including
the Food and Drug Administration and the Drug Enforcement Administration, are
looking at methadone to determine how much of the problem is due to the drug
getting into the wrong hands.”