Pubdate: Sun, 25 May 2008 Source: Asheville Citizen-Times (NC) Copyright: 2008 Asheville Citizen-Times Contact: http://www.citizen-times.com/ Details: http://www.mapinc.org/media/863 Author: Mike McWilliams and Jon Ostendorff Bookmark: http://www.mapinc.org/find?136 (Methadone) METHADONE DEATHS RISE IN NC CANTON - Jim and Theresa Kuykendall knew little about methadone before the overdose death of their only child. Andrew "Skip" Kuykendall had been a few days shy of turning 21 when his grandmother found him dead in the Kuykendall home, the victim of a drug that has been linked to more deaths statewide than cocaine between 1999-2006, records show. The problem has become particularly severe in North Carolina, where methadone overdose deaths soared from 48 in 1999 to 354 in 2006, a more than 600 percent increase, according to state records. North Carolina from 2002-2004 ranked second only to Florida in the number of methadone deaths, according to the U.S. Department of Justice. "I was a big fan of Anna Nicole Smith, and I heard that word mentioned with her son and a little bit with her," Theresa Kuykendall said. "But I had no clue. The only thing that I'd ever heard of kids taking around here was Xanax." The Kuykendalls are convinced someone slipped their son methadone without his knowledge at the time of his Oct. 18 death, or that he didn't know what he was taking. When used correctly and in a treatment setting, methadone saves the lives of countless patients suffering from opiate addiction. Alarming numbers But misuse and abuse of the drug has been linked to the deaths of 1,657 North Carolinians between 1999 and 2006, including 298 in Western North Carolina. The state saw 1,525 cocaine overdose deaths during that span. Most people who have died from abuse of the cheap and readily available drug have been men 35-44 years old. Buncombe County had the fourth-highest death toll statewide at 55 during the seven-year period, state records show. Gaston County topped the list at 73. Methadone was linked to nine deaths last year in Buncombe County, state records show. "The thing about methadone is that it's here to stay because it's a prescribed therapy to get somebody off an opiate-based narcotic," Haywood County Sheriff's chief detective Larry Bryson said. "We're just going to have to deal with it the best we can." A cheap high Methadone has been around since about 1940. A German scientist created it as a pain medication during World War II. It showed up in the United States in 1947 as a treatment for heroin addicts and had been primarily used in that way ever since. It comes in pill and liquid forms. The 1ent of another drug recently brought methadone back to its original use. Doctors started prescribing methadone for pain more often in the wake of the widespread abuse of oxycodone in the late 1990s, said Rojene Wiate, a U.S. Drug Enforcement Administration spokeswoman. Oxycodone is the ingredient in the brand-name drug OxyContin. It can produce a heroin-like high and is extremely addictive. Methadone can produce a high for people who are not already opiate users, said Frank Vocci, of the government's National Institute on Drug Abuse. The strength of the high depends on how tolerant the user is to opiates. For heroin addicts, the drug would not create a euphoric or pleasurable effect. But for people who had never used heroin, it could be powerful. Cost is one factor in both the increase in sales and the increase in deaths, said Rhonda Roberts, of the Injury and Violence Prevention branch of the state Division of Public Health. At $20 for a month's worth -- according to 2004 prices -- it is drastically cheaper than an equivalent drug like Demerol, which costs about $120 a month. Another factor could be a lack of support for methadone clinics because of the drug's stigma. This could mean heroine addicts are choosing to medicate themselves with methadone they buy on the street and end up overdosing, Roberts said. Deadly buildup The drug can be particularly deadly for unsupervised users because of the time it lasts in the body. Most people can metabolize methadone in 15 to 60 hours. That means addicts might take doses for days trying to get high and then reach a deadly threshold because of the drug's buildup. Vocci said there are unanswered questions about methadone that make it hard to pin deaths solely on the drug. In many cases, he said, users have died while taking methadone and other drugs or alcohol. And, he said, even the most recent studies on the drug don't provide answers about how people are dying. A drug-related death in the middle of the day from a sudden heart attack is different from a death in the middle of the night from cardiac problems brought on by breathing trouble. Side effects of methadone include dangerously slow breathing and sleep apnea. More good than harm But people who treat addicts say methadone does more good than harm. "The effectiveness of methadone in treating opioid addiction has been well-researched and documented," said Brian Goodlett, program director at Western Carolina Treatment Center Inc. in Asheville. "Our internal data indicates that more than 90 percent of our patients discontinue illicit opioid use within three months of beginning treatment." The center is the second-largest opioid treatment center in North Carolina and serves approximately 500 patients. The center has diversion control policies that include requiring patients to return for random inspections of unsupervised doses, random drug screenings and investigating any rumors or suspicions that a patient may be abusing or diverting methadone, Goodlett said. "If we have reasonable suspicion that a patient is involved in some type of diversion activity, we will discontinue prescribing methadone and attempt to refer that person to some type of alternative treatment modality such as an inpatient program," Goodlett said. Skip's story Theresa and Moose Kuykendall describe their son, Skip, as a strong-minded, outgoing person, who was a hard worker and well liked by everybody. He graduated from Pisgah High School in 2005 and continued his education at the Motorcycle Mechanic Institute in Orlando, Fla. The Kuykendalls planned for Andrew to eventually take over the family business, Trackside Racers Supply Inc., a road race tire distributor that travels to motorcycle races across the country. He was engaged to marry Krista Jones, his parents said. Andrew also loved playing sports, including basketball and soccer. He got his nickname, "Skip," from the way he trotted down the basketball court. The only drug the Kuykendalls knew their son had done was some marijuana, and he occasionally drank alcohol. "He was by no means perfect. He made mistakes," Theresa Kuykendall said. "Sometimes he could just be a typical teenager, a pain in the butt." A different crowd Shortly before his death, Andrew started hanging out with a different crowd, whom the Kuykendalls didn't know. These people weren't his friends, but acquaintances, his parents said. It's these acquaintances who the Kuykendalls believe gave their son methadone. Andrew's grandmother saw two boys with him in the Kuykendalls' home the day Skip was found dead. "She yelled at Andrew to get up, and when he didn't respond, she went down there, and that's when she realized," Kuykendall continued. "She said he looked like he was asleep, but he was cold." "She screamed, they jumped and left," Theresa Kuykendall said. "They didn't say anything." Haywood County Sheriff's Office initially investigated the incident as a "suspicious death case." It later was ruled an overdose death by the Sheriff's Office and the State Medical Examiner's office. "I'm very frustrated and very upset, but I just want to prevent this from happening to somebody else," Theresa Kuykendall said. "The pain is beyond anything I could imagine." - --- MAP posted-by: Jay Bergstrom