Pubdate: Sat, 09 Feb 2008
Source: Tampa Tribune (FL)
Copyright: 2008 The Tribune Co.
Contact: http://www.tbo.com/news/opinion/submissionform.htm
Website: http://www.tampatrib.com/
Details: http://www.mapinc.org/media/446
Author: Elaine Silvestrini
Bookmark: http://www.mapinc.org/find?136 (Methadone)

RISE IN METHADONE DEATHS ALARMING, FLORIDA'S EXPERTS SAY

TAMPA - Formerly a drug used only to treat heroin addiction, 
methadone has become more popular in recent years to treat pain.

As the use of the drug increases, related deaths are rising at an 
"alarming rate," according the National Drug Intelligence Center. 
Florida has become one of the leading states for methadone overdose 
deaths, according to the Center for Disease Control.

Now, authorities are wondering if methadone may be fatal even in 
therapeutic doses.

"I would never let anybody in my family take methadone unless they 
were a heroin addict to begin with," said Hillsborough County Medical 
Examiner Vernard Adams.

The chairman of the Florida Medical Examiners Commission on Friday 
distributed a study to other commissioners citing increased instances 
of sudden deaths among methadone users.

Researchers in Oregon reported in the study published last month that 
methadone has been implicated as a likely cause of sudden death at 
therapeutic doses. In the study published in the American Journal of 
Medicine, the researchers recommended clinical safeguards and further 
studies designed to enhance the safety of the drug.

Adams said he's also noticed some methadone-associated deaths that 
are different from other deaths attributed to drug overdoses.

In addition to the fact that deaths are occurring at therapeutic 
doses, Adams said some methadone deaths involve heart issues. Most 
drug overdoses involve respiratory failure, Adams said.

Adams, however, said he has no statistics and cannot cite specific 
cases related to this possible phenomenon. He said he just has a 
general sense that this is something that should be examined.

"The fact that these people are dying from methadone at therapeutic 
concentrations, this is anecdotal," he said. "We haven't studied it 
the way these people in Oregon have."

In Hillsborough County, methadone was listed as a contributing cause 
in 37 deaths in the first six months of last year. Methadone was 
listed as the only cause in five deaths. In 2006, methadone was 
listed as a cause in 49 deaths, according to medical examiner data. 
In 10 deaths, methadone was listed as the sole cause. In 2005, 
methadone was listed as a cause in 30 deaths in the county and as the 
sole cause in 10 more.

The numbers reflect a trend in Florida, where methadone was listed as 
a cause in 392 deaths in the first six months of 2007 and in 716 
cases in all of 2006, compared with 2005 when the drug was a cause in 
620 deaths.

Stephen J. Nelson, the chairman of the state Medical Examiners 
Commission, distributed the Oregon study at the commission's regular 
meeting. Nelson said in an interview after the meeting that he wanted 
medical examiners to be aware of the potential problem and to be on 
the lookout. It's possible, he said, that the commission may attempt 
to track methadone levels in the deceased.

In November, the National Drug Intelligence Center published a study 
titled, "Methadone Diversion, Abuse and Misuse: Deaths Increasing at 
Alarming Rate." According to the report, the quantity of methadone 
dispensed nationwide more than tripled between 2001 and 2006.

The report described methadone as "safe and effective when used as 
prescribed," but said the drug has increasingly been misused and abused.

Methadone has been used in addiction treatment for the past 50 years, 
according to the report, which noted that the drug's use in pain 
management has increased steadily since the late 1990s. Physicians 
turned to methadone as an alternative to oxycodone and hydrocodone, 
which were being increasingly abused. It also can be used less 
frequently and is less expensive than other drugs, the report states.
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