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 Author: Scott Jenkins Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?136 (Methadone) METHADONE CAN WEAN ADDICTS OFF OTHER DRUGS, HELP WITH PAIN Methadone is a synthetic opiate. German scientists created the drug in 1937 as an easier-to-administer and less potentially addictive alternative to morphine to control pain during and after surgery. Eli Lilly and Co. introduced methadone in the U.S. in 1947 as a painkiller, but it became widely used, and best known, decades later as a drug for weaning addicts off heroin. Since the late 1990s, doctors have increasingly prescribed methadone to patients who suffer from chronic or severe pain, and experts say that widening availability has led to a rising death toll from methadone overdoses. Nationally, overdose deaths involving methadone rose from 831 in 1999 to 4,031 in 2004, according to the most recent information available from the National Center for Health Statistics. In North Carolina, methadone-related deaths rose nearly 10-fold between 1999 and 2006. And in Rowan County, the drug was a factor in almost half the overdose deaths between 2003 and 2005. People who study overdose deaths and perform toxicology tests say very few people are overdosing on the liquid form of the drug given in methadone clinics. The vast majority are dying after taking too much of the prescription version, they say. A lot of those deaths, experts say, result from people taking prescription drugs that aren't theirs for pain, or looking for a way to a high, which methadone doesn't produce like other drugs. But Kay Sanford, a public health epidemiologist in the Injury and Violence Prevention Branch of the state Division of Public Health, said that even patients legitimately prescribed methadone for pain need to be under close medical supervision while getting used to the drug, which reacts differently in different people. Typical side effects of methadone include drowsiness and respiratory depression. In a public health advisory last year, the Food and Drug Administration said signs of overdose may include trouble breathing or shallow breathing, extreme tiredness or sleepiness, blurred vision, inability to think, talk or walk normally and feeling faint, dizzy or confused. Sanford said a person who has overdosed on methadone might also be snoring when he usually does not, a sign that it's getting hard to breathe. Sanford said doctors need to stress to patients to keep their prescriptions secure, especially if they have children or teens in the house. "They need to tell patients that even a small dose of methadone can be fatal to kids or teenagers," she said. Pharmacists dispensing methadone should ask patients if they have contact with children and adolescents and explain the dangers, she said. Patients taking methadone need to be aware of its possible hazards and the potentially lethal consequences of not following a doctor's instructions, Sanford said. "Some pills are more lethal than others, and methadone appears to be more lethal than many narcotics," she said. "... Even an extra pill or two of methadone can be lethal." And for children and teenagers, she said, avoiding death by overdose is "very simple: If you don't use drugs, don't start. If you do use drugs, stop, get help." - --- MAP posted-by: Beth Wehrman