Pubdate: Sun, 20 Jul 2008
Source: News & Observer (Raleigh, NC)
Copyright: 2008 The News and Observer Publishing Company
Author: James Finch, M.D.


Regarding your July 13 article on methadone-related deaths in North
Carolina: Public awareness is an important part of how we need to respond to
these alarming developments. For some, methadone has been a useful,
inexpensive treatment for chronic pain. For others it has been the only
effective path away from addiction. Methadone's benefits are well
established. We must do a better job of minimizing its potential risks.
As stated in the article, most methadone overdoses occurred in those using
methadone without prescription. Only a small percentage was related to those
being prescribed methadone for addiction treatment, and seldom was the
methadone diverted from these settings. This does not minimize the
importance of safe prescribing practice. Methadone must be used selectively,
with appropriate dosing, education and monitoring. Training and support for
those prescribing methadone, including those prescribing it within the
addiction treatment setting, are vital.

However, in addressing concern about overdoses, we must be careful not
to limit access to a valuable treatment tool for those who need it. To
do so may actually hamstring our ability to respond to the escalating
abuse of opiates in our communities.

James Finch, M.D. President, N.C. Society of Addiction Medicine
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MAP posted-by: dan