Methadone prescription drug abuse accounts for almost one in three prescription painkiller overdose fatalities in the United States, although only two percent of opioid painkiller prescriptions are for methadone, according to one recent report by the CDC (Centers for Disease Control and Prevention). This report additionally discovered that 6 times as many individuals died of methadone-associated overdoses in 2009, as compared to ten years earlier.
Methadone treatment has been safely used to treat addiction since the early 1960s, yet in recent times, pain relief prescriptions have increased. In November of 2006, federal officials warned against the use of methadone treatment as an initial-option pain reliever, because it is so tricky to safely prescribe, yet prescriptions have not declined much. Therefore, in tandem, rates of nonmedical methadone use rates and deadly overdoses have increased; the drugs included in these instances are usually diverted from pain treatment, not from treatment programs for addiction.
Therefore, why is methadone more fatal while utilized to treat severe pain? Because it is long-lasting and it builds in the body. The drug kills pain for around 6 hours on average, yet with accumulating doses, it may retard an individual’s breathing and interrupt heart rhythm — effects which may last for days. This means that consuming methadone 3 times per day — as prescribed — may cause a potentially deadly overdose if an individual isn’t completely tolerant to methadone. Worse, the effects widely vary from one person to another.
The methadone prescription drug abuse issues revert back to the 1990s and 2000s, as drug addicts found that a new painkiller named Oxycontin might be injected or snorted to produce a powerful high — and get around the pill’s time-release nature. Purdue, oxycontin’s manufacturer, eventually was fined $634 million for selling the medicine as less addictive than additional opioids. With scrutiny from law enforcement intensifying on the prescribing of Oxycontin, physicians started searching for a drug which possessed similarly long-lasting pain effects.
Methadone ended up perfectly fitting the bill. Not only is methadone one of the longest acting opioids, it is additionally generic and around twelve times less expensive than Oxycontin (brand name). Its lengthy history of safe usage in addiction treatment also may have made it appear less risky than it is, causing most insurers and a few state health programs to place it on their formularies as their preferred drug, which meant that it’d be covered as additional similar medicines such as Oxycontin wouldn’t be.
However, there is a major difference between pain patients and addiction patients: individuals taking methadone for maintenance treatment possess a lengthy opioid use history — that is why they are in treatment — and thus, a high tolerance to the whole class of drugs. This means that as a population, they’re already self-selected to have the ability to successfully manage large opioid doses.
Additionally, the methadone doses utilized in maintenance treatment for addiction are carefully controlled. The initial dose is small — the difference in between dangerous and appropriate methadone dose is small — and patients are not permitted to take home the drug until they’ve proved through months of day-to-day drug-free urine tests and program attendance that they’re tolerant to it and may safely use it. In contrast, many methadone prescribing for pain is performed by general practitioners and additional non-specialists who do not possess pain management training.