More on Methadone Overdose


The rapid rise of the number of deaths by methadone overdose is receiving attention all over the country.

Maurreen Skowran of The News & Observer reported on the increase of methadone deaths in North Carolina as the drug is used more commonly as a painkiller. In her article, found here, Skowan reports on the deadly effects of the drug, even when used as directed.

"Even legal prescriptions can turn fatal when doses accumulate over time into overdoses.

That phenomenon may have contributed to the death of a Winston-Salem woman. Jewel Imperial, 25, a student and musician, overdosed in September 2007. Her father, Bobby Imperial, said she died five days after being prescribed up to 80 milligrams per day for back pain. He declined to identify her doctor because the family is pursuing legal action. Imperial's dosage was more than double the recommended maximum for patients new to opioids, the family of drugs that includes methadone. Her parents didn't know she had been prescribed methadone then. But a few days after she started the prescription, her mother, Nancy Imperial, took her back to the same doctor. Her symptoms were disorientation, aches, sweats, cough and, sometimes, a spacey feeling, her father wrote. She died the next day."

Spike Hurst of reported on methadone's effects in Pennsylvania and the surrounding region in his "Killer or Cure," found in its entirety here. According to the article, methadone could be the region's number one killer.

"It's killing people at therapeutic levels," said Marti Hottenstein, vice president of Helping America Reduce Methadone Deaths, a grass-roots group battling to tighten regulations on the drug. "It's killing more than illicit drugs - drugs it's supposed to help people from."

Hurst's article emphasizes the critical need for education about methadone, quoting Dr. Westley Clark, of the Substance Abuse Treatment Center director for the U.S. Department of Health's SAMHSA agency, the Substance Abuse and Mental Health Services Administration.

Inside state-regulated clinics, education and counseling are part of methadone maintenance programs, Clark said.

Those added measures - combined with "lock boxes" for take-home doses - something SAMHSA recommends - all work to curb the likelihood of overdosing, as well as opportunity for thefts, he said.

But with practitioners, "there has to be a greater emphasis placed on educating them about the dangers of opiates like methadone," said Clark, who believes that, in many cases, there may be better alternatives for pain treatment. He says SAMHSA is working on drug policy and with the federal Drug Enforcement Administration on strategies to "encourage" practitioners to learn more about methadone.

Because things could get worse, Clark said."We need to reach out to patients, the public and the media because we need to be aware that we have a boomer population that will be running into more pain problems associated with getting older. There's going to be that demand [for pain medication]."

His message to physicians: Know the drug. "Know the drug and know your patient," Clark said, because it might be the best option available for those who cannot afford high-priced anesthetics.