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."
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