Deadly Drugs: The Methadone Abuse Epidemic

Prescription painkiller overdoses were responsible for more than 15,500 deaths in 2009, according to a CDC Vital Signs report released today by the Centers for Disease Control and Prevention. While all prescription painkillers have contributed to an increase in overdose deaths over the last decade, methadone has played a central role in the epidemic.

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“Deaths from opioid overdose have increased four-fold in the past decade, and methadone now accounts for nearly a third of opioid-associated deaths,” said CDC Director Thomas R. Frieden, M.D., M.P.H.

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Methadone is frequently prescribed for pain.

• Methadone, like other painkillers, is commonly prescribed for chronic problems like back pain even though it might not help these problems in the long run.
• More than 4 million methadone prescriptions were written for pain in 2009, despite US Food and Drug Administration warnings about the risks associated with methadone.
• Methadone is available as a low-cost generic drug. It is often listed as a preferred drug by insurance companies.

Methadone’s risks include:

• The difference between appropriate prescribed doses and dangerous doses of methadone is small.
• Methadone has special risks as a painkiller. For example, taking it more than 3 times a day can cause the drug to build up in a person’s body, leading to dangerously slowed breathing.
• Methadone can seriously disrupt the heart’s rhythm.
• Methadone can be particularly risky when used with tranquilizers or other prescription painkillers.
• In one study, four in ten overdose deaths involving single prescription painkillers involved methadone, twice as many as any other prescription painkiller.

Health care providers can:

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• Follow guidelines for prescribing methadone and other prescription painkillers correctly, including
  • Screening and monitoring for substance abuse and mental health problems.
  • Prescribing only the quantity needed based on the expected length of pain.
  • Using prescription drug monitoring programs to identify patients who are misusing or abusing methadone or other prescription painkillers.
  • Monitor patients on high doses for heart rhythm problems.
  • Educating patients on how to safely use, store, and dispose of methadone and how to prevent and recognize overdoses.

Health insurers can:

• Evaluate methadone’s place on preferred drug lists.
• Consider strategies to ensure that pain treatment with any dose higher than 30 mg of methadone a day (the recommended maximum daily starting dose) is appropriate.

Individuals can:

• Use methadone only as directed by a health care provider.
• Make sure they are the only ones to use their methadone and never sell or share it with others.
• Store methadone in a secure place and dispose of it properly. See www.cdc.gov/HomeandRecreationalSafety/Poisoning/preventiontips.htm for correct storage and disposal of medications.
• Get help for substance abuse problems (1-800-662-HELP or www.samhsa.gov/treatment/).