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."
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