I was reading an article entitled “The Methadone Poisoning Epidemic” in The Forensic Examiner magazine (sorry no link, it was paper) and I wanted to share a few points with you.
Using information from a National Center for Health Statistics report the author relates that in 2003 methadone-related deaths rose 29%, while drug related deaths as a whole only increased 6%. In addition, methadone was responsible for more deaths than any single prescription painkiller listed (that doesn’t reflect our experience while we see these sorts of methadone overdose deaths, those with hydrocodone and oxycodone are in higher numbers here). The number of unique patient prescriptions for methadone increased 80% through 2005 and 2006 (in most cases prescribed for pain management).
The real key and the point the author really stresses is that methadone overdoses occur by in large in folks using methadone as a pain medicine, not in folks on methadone as maintenance therapy for opiate addiction. This is primarily because while the drug half life in the body is 24 to 36 hours, the pain relief effect lasts 4-6 hours. While the intent is to reach steady state for pain modulation, folks start chasing their pain with additional doses. Those additional doses build over time because of the long “real” half life with lethal consequences.
This lethality is compounded by concomitant use of other medications and certain underlying medical conditions, like sleep apnea and prolonged QT interval heart conduction problems.
Methadone is a dangerous drug for pain management and many don’t realize that (patients and doctors alike). It should be used with caution and only with a physician very familiar with the drug and with highly motivated and conscientious patients.