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Sunday, July 8, 2012

Methadone overdose deaths fall a little after huge increase since 1999.

The AP (7/5, Stobbe) reports that a Vital Signs report from the Centers for Disease Control finds that "after a sharp rise, the number and rate of methadone-related overdose deaths have fallen since 2007," having risen "from fewer than 800 in 1999 to more than 5,500 in 2007, before slipping the next two years to 4,900 and 4,700." CDC director Dr. Thomas Frieden commented, "There aren't a lot of problems that have gotten so much worse so quickly as prescription drug overdose has." And "besides methadone, painkiller deaths primarily involve Vicodin (hydrocodone), OxyContin (oxycodone) and Opana (oxymorphone)." Methadone "accounted for just 2 percent of painkiller prescriptions in 2009, but more than 30 percent of overdose deaths." Methadone has been prescribed as "a safer alternative," to OxyContin, and "because it's cheaper than some other painkillers," but it "can disrupt breathing," and "can cause a fatal irregular heartbeat."
        CBS News (7/5) explains, "methadone carries more risks than other painkillers because levels build up in the body and may interfere with a person's normal heart rhythm or breathing." Frieden said, "Deaths from opioid overdose have increased four-fold in the past decade, and methadone now accounts for nearly a third of opioid-associated deaths," adding, "There are many safer alternatives to methadone for chronic non-cancer pain." The story notes that "the rise in deaths even prompted a 2006 warning from the Food and Drug Administration regarding careful prescribing of the drug."
        Reuters (7/3, Ebrahim) also quotes Dr. Frieden advising physicians that "there are many safer alternatives to methadone." He also said, "Although it may cost a couple of dollars less per pill, the result is many more emergency room visits, and a much higher societal cost in deaths, and addiction and other problems that can be avoided."
        The Boston Globe (7/3, Kotz) reports in its "Daily Dose" blog, "Many of these deaths could be prevented if doctors curtailed their prescribing of this drug, said the federal Centers for Disease Control and Prevention." It also quotes Dr. Frieden saying that prescribing methadone for chronic non-cancer pain is "penny wise and pound foolish."
        The CNN (7/5) "The Chart" blog reports, "If you are not grappling with cancer-related pain, you probably should not be taking prescription methadone." Dr. Frieden said, "It should only be used for pain when other drugs haven't been effective."
        The Salt Lake (UT) Tribune (7/5, May) reports, "In Utah, the number of methadone-related deaths has dropped as efforts to educate physicians and the public have increased." Those efforts include a 2006 warning by the FDA, as well as a 2008 move by manufacturers to limit "distribution of the largest formulation to authorized opioid addiction treatment programs and hospitals only." And "in 2009, the Utah Department of Health issued guidelines telling doctors to rarely if ever prescribe methadone for acute pain."
        Time (7/5, Szalavitz) reports in its "Healthland" blog, "Methadone kills pain for about six hours on average, but with accumulating doses, it can slow a person's breathing and disrupt heart rhythm," and "this means that taking methadone three times a day - exactly as prescribed - can lead to a potentially fatal overdose."
        MedPage Today (7/5, Fiore) reports that Frieden "emphasized that most of these accidental deaths are tied to the drug's use in chronic pain -- a condition for which there is little evidence of its benefit, he noted -- and are not associated with its indication for the treatment of substance abuse." HealthDay (7/5, Reinberg) also covers the story.

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