Pubdate: Sun, 25 Mar 2007 Source: Salisbury Post (NC) Copyright: 2007 Post Publishing Co. Contact: http://www.salisburypost.com/ Details: http://www.mapinc.org/media/380 Bookmark: http://www.mapinc.org/find?136 (Methadone) METHADONE AND ITS RISKS Administered under the supervision of a knowledgeable physician, methadone is a powerfully effective drug that can help alleviate chronic pain or wean addicts away from their dependence on illegal narcotics. Used improperly, methadone can be as lethal as an overdose of heroin or cocaine. A series on methadone beginning in today's Post describes how the drug's increasing popularity as a legally prescribed painkiller -- and its illicit use as a street drug -- has brought a tandem rise in unintentional overdose deaths. Nationally, it's estimated that methadone overdose deaths have risen almost 400 percent since 1999. That year, overdoses accounted for 623 deaths, according to health experts. By 2003, the number of overdose deaths had rocketed to 2,452. In Rowan County, methadone has been implicated in nearly half the unintentional overdose deaths registered between 2003 and 2005. Considering the alarming list of potential side effects that accompanies almost any prescription medication these days, perhaps it should come as no surprise that a powerful synthetic opiate such as methadone could pose catastrophic consequences if taken in doses beyond those prescribed in a clinical setting. What makes methadone especially problematic, however, is that it is highly addictive, although it doesn't offer users a typical "high," and it can stay in the body for more than two days after its analgesic effect has subsided. Whether it's an abuser popping pills in search of a non-existent high or a patient seeking relief from pain by going beyond the prescribed amount, the overdose danger is the same: Methadone can quickly build up to toxic levels, an effect exacerbated if someone is taking other drugs at the same time. By the time a patient recognizes signs of trouble such as irregular or shallow breathing, sleepiness, dizziness or confusion, he or she may not be able to get help. For drug abusers who buy pills off the street or swipe them from a medicine cabinet, warnings about methadone's risks may have little impact. Despite widespread publicity about the dire health consequences of crack cocaine and methamphetamine, for instance, addicts still widely abuse those drugs -- and methadone is much cheaper. What might discourage someone tempted to sell methadone illegally, however, is the possibility of a murder charge. N.C. Sen. John Snow has proposed a change in state law that would allow second-degree murder charges against anyone who illegally provides the methadone that causes a fatal overdose. While harsher penalties may help discourage the illegal sale of methadone, the remedy for reducing deaths among legitimate users should be obvious. Doctors need to stay abreast of the latest prescription guidelines, and patients need to scrupulously follow dosage instructions while paying attention to any symptoms of a possible overdose. As always, vigilance -- and competent medical care -- are the patient's best defense. - --- MAP posted-by: Beth Wehrman