Methadone Articles

Help or Just Another Way to Feed the Problem

The very drug that abusers are being prescribed to kick the habit is also increasingly linked to overdose deaths in the United States.

According to a recent article, a branch of the Department of Health was cited as saying one in ten overdoses are from the use of methadone. Methadone is often one of the drugs given in drug rehabilitation centers to help addicts detox and is also used as a pain killer treatment.

Methadone is becoming one of the drugs that addicts covet and will steal to get, as well as a cause of additional health problems. So this begs the question, why is a drug that is now known to have such adverse reactions and has such addictive potential still a part of drug detox?

Could it be a case that the positives outweigh the negatives? With the number of overdose deaths on the rise due to drug overdose and the rise in substance abuse addictions, this treatment could provide the opportunity for an addict to detox off of a substance that has taken over his/her life.

There are no full-proof ways to kick a drug habit, but methadone has long been one of the treatments used as addicts are weaned off their addictive substance.

Methodone has been an important part of rehab treatment for some individuals. As treatment options continue to expand and are being developed, perhaps there will be new options for patients that won’t have the potential to be as addictive.

Deaths from Methadone Increasing

In 2006, 17-year-old Tim Zigler came home one evening and quickly went to bed. The next morning, his father found him unconscious and barely breathing. He died before an ambulance arrived.

The Spokane, Washington teenager had taken methadone that previous night before coming home, said his father, Ken Zigler. “Tim didn’t have any tolerance for methadone,” said Zigler, who called the drug “horribly dangerous.”

Andy Miller writes in an article for MSNBC.com that a new federal report found that the number of deaths involving methadone jumped nearly sevenfold from 1999 to 2006.

The rise in methadone-related fatalities was faster than increases in deaths from other opioid analgesics—drugs such as OxyContin and fentanyl—and from other narcotics.

Overall, poisoning deaths involving all opioid analgesics more than tripled over the seven-year time frame, increasing among all age groups, said the report from the U.S. Centers for Disease Control and Prevention.

Methadone is widely known for treatment of heroin addiction, but it has been increasingly prescribed to manage pain.

In March, a report by the U.S. Government Accountability Office said methadone’s growing use for pain management has made more of the drug available, contributing to an increase in methadone-related overdose deaths.

Methadone prescriptions for pain management jumped from about 531,000 in 1998 to more than 4 million in 2006, the GAO found. Deaths related to the drug can occur from improper dosing levels, misuse by patients who may combine it with other drugs, or abuse of the drug for non-medical purposes, the agency said.

The CDC report said “a lack of knowledge about the unique properties of methadone was identified as contributing to some deaths.”

“We’ve been watching the trend in methadone deaths,” said Margaret Warner, an epidemiologist with the CDC’s National Center for Health Statistics and a co-author of the report. “Methadone has a long half-life. It stays in your body.”

The methadone poisonings have continued in the last two years, Warner said. “There have been some programs to address the problem. We’re hoping they decrease the deaths.”

Methadone is effective in treating heroin and pharmaceutical opiate addiction, said Caleb Banta-Green, a research scientist with the University of Washington’s Alcohol and Drug Abuse Institute. It’s also a good pain management drug if taken exactly as prescribed, he said.

But the rising death rate from methadone, especially from prescriptions, is not surprising because of its increased overall use, Banta-Green said. “If they take it when it’s not prescribed, it’s dangerous. If you’re not opiate-tolerant, it could kill you.”

Zigler now talks about methadone and his son’s death to teen groups. “My son’s death is tragic enough,” he said. “I’m trying to turn something horrible into something good—by educating the teens of the dangers of prescription drugs, especially methadone.”

Coroner Questioned in Methadone-Related Death

A methadone-related death is being investigated in Lake County, Chicago, after officials learned that the county’s coroner, Dr. Richard Keller, prescribed the drug to the victim at a Waukegan clinic, where Keller is medical director.

The Chicago Tribune reports that the DEA is participating in the investigation, which includes a review of whether Keller and clinic staff followed proper procedures in administering methadone, commonly used to treat heroin addiction. In addition, a state agency has faulted the clinic for not reporting the death as required.

Steve Vaughn, 30, of Lindenhurst died hours after he was administered 70 milligrams of methadone on December 3, 2008, at the Green Dragonfly clinic during his second day of treatment, Keller said.

State’s Atty. Michael Waller questioned why Keller investigated his own patient’s death, as this is a potential conflict of interest. The coroner typically determines if any foul play was involved with an unnatural death. “The whole situation is just questionable,” Waller said. “The coroner is supposed to determine the cause of death, and in this case the coroner issued methadone to a person who never had it before.”

Keller began working for the clinic shortly after it opened in October 2008 to treat patients who are addicted to opiates. When Vaughn’s mother returned home from work to find her son dead on December 3, Keller investigated the death and concluded that Steve died from mixing methadone and Xanax.

Vaughn had not been prescribed Xanax and was using someone else’s medication, said Keller, a licensed physician. He concluded that Vaughn did not overdose on either drug, but likely went into respiratory arrest after mixing the two, which is known to be a potentially lethal combination. “He had mixed methadone and Xanax, which he had been warned against taking [together],” Keller said.

Keller said he does not believe there was a conflict of interest in having his office investigate the death. “We handled it like any other case,” Keller said. “It’s like any other doctor who signs a death certificate for his patient, which happens all the time.”

Vaughn’s mother, Jill, said she was not aware that Keller was the same doctor who prescribed her son’s methadone. She said he was addicted to Xanax, not heroin. She also said that she believes her son lied to clinic staff so he could enroll in the methadone treatment program, having been turned down by other health clinics.

Steve was accompanied by his brother, who said he didn’t hear any staff members warn Steve about the dangers of mixing methadone with Xanax. “He didn’t tell them anything about Xanax; he just wanted to get on methadone to get off Xanax,” his mother said.
“When you are dealing with drug addicts, you are dealing with liars and thieves,” she said. “[Green Dragonfly] didn’t even do a minimal urine test to see if he had anything in his system.”

Waller also questioned whether Keller tested Vaughn’s blood to determine which drugs were in his system before providing the methadone. Keller said Vaughn underwent a routine physical exam before being treated with 40 milligrams of methadone his first day and 70 milligrams the next.

Richard Weisskopf, state opiate treatment authority for the Department of Human Services’ Division of Alcoholism and Substance Abuse, said that state officials inspected the clinic two weeks ago and found that the clinic did not report Vaughn’s death, as is required of all methadone-related deaths. Keller said he reported the man’s death to state and federal agencies, though possibly not in a timely manner.

First elected to the position of county coroner in 2004, Keller recently announced he did not intend to seek re-election when his term ends in 2012. He blamed politics, saying it interfered with other educational programs he was involved in, such as suicide prevention and adolescent substance abuse.

Keller said he thought the state’s attorney’s inquiry was politically motivated. “Certainly when you look at the facts in the case, there certainly was no crime that occurred,” he said. “Unfortunately, a young man died. Unfortunately, these things happen.”