Pubdate: Sun, 29 Oct 2006 Source: Tulsa World (OK) Copyright: 2006 World Publishing Co. Contact: http://www.tulsaworld.com/ Details: http://www.mapinc.org/media/463 Author: Leigh Woosley, World Staff Writer, The Tulsa World Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?136 (Methadone) METHADONE DEATHS ON INCREASE IN STATE The rise in abuse is attributed to more of the drug being prescribed. A swelling number of Oklahomans are dying from methadone poisoning, a recent report shows. The numbers are alarming, a state toxicologist says. The prescription drug directly caused 43 deaths in the state last year, according to a report from the Office of the Chief Medical Examiner. During that same time, methadone was found in various mixtures of drugs that killed 75 other people. The drug -- best known as a means to ease withdrawal symptoms of recovering heroin addicts -- is increasingly being used as a prescription painkiller and is showing up in illegal drug sales. "Methadone is definitely on the streets, and it's certainly alarming, the increase in the number of (death) cases," said Philip Kemp, chief forensic toxicologist at the Medical Examiner's Office. "We've seen a dramatic increase over the years. Now, does that mean they should stop prescribing it (methadone)? I don't think so. Certainly everyone is taking a closer look it." The number of drug-related deaths involving methadone has nearly tripled in recent years. It was 45 in 2001, 98 in 2003 and 118 in 2005. The Tulsa Police Department reported recently that methadone-related arrests are up. Methadone is a volatile substance that stays in the body much longer than other drugs like it, building up to toxic levels. Methadone, a synthetic addictive opiate first made by the Germans during World War II and then used to detoxify heroin addicts, is now widely abused. People abusing methadone get it many other ways. They fake pain to one doctor who gives them a prescription. They doctor-shop, going from doctor to doctor, telling false stories of pain and hoarding prescriptions. Abusers steal and forge physician prescription slips. And for enough money, the opiate is always online. "You can get anything on the Net," said John McKenna, a special agent with the U.S. Drug Enforcement Agency. The increased misuse of methadone is mostly due to the increased use of the drug for pain and not its treatment for heroin addiction, according to the "Methadone-Associated Mortality, Report of a National Assessment" from the U.S. Substance Abuse and Mental Health Services Administration. The report found that from 1998 to 2002 prescriptions for methadone through pharmacies increased fivefold and just 1.5-fold through opiate treatment programs, where the drug is typically used to detoxify heroin addicts, the report said. "I think most of these increased deaths are not coming from methadone clinics because they know what they do and they do it the right way, whether you agree with it or not," said Dr. William Yarborough, medical director of internal medicine at the University of Oklahoma-Tulsa. Yarborough is an addictionologist with a specialty in pain management. "There is more methadone on the street because more of it is getting prescribed. I see patients who take methadone in doses that if you or I would take it would kill us." He said doctors are prescribing methadone more often for pain because it's cheaper than oxycodone and it works well for nerve-related pain, which often includes the common complaint of back and neck pain. The use of prescription painkillers in general is up because the medical field is shifting its approach to chronic pain, Yarborough said. "It's becoming more acceptable to treat people's chronic pain," he said. "Not only more acceptable, it's becoming seen as something you should do." He stressed that opiates and related drugs are not dangerous unless they're abused and misused. "You can't keep 100 chronic-pain patients from getting relief because one person is conning doctors," he said. Still methadone warrants greater caution because it is more perilous than many other drugs like it. Drug researchers pay attention to a drug's half-life, how much time it takes to metabolize half of the dose. The half-life of most painkillers is several hours. Methadone has a half-life from 12 hours to five days, Yarborough said. So more doses or other drugs and alcohol taken while methadone is still in the system can be deadly. "You have a very short safety frame on this (methadone)," said Margaret Berry, a nurse and detox specialist at St. John Behavioral Health Services. Methadone can mix sometimes in life-threatening ways with other medications like those for anti-anxiety and antidepression and cause unexpected problems. "People are getting in trouble quicker with methadone because it doesn't take much to overdose on it," she said. "They take a (methadone) pill, someone gives them some alcohol. They're playing with it, but they just don't realize they are brewing a drug cocktail that will kill them." - --- MAP posted-by: Richard Lake