Methadone linked to one-third of prescription pain reliever deaths – The Chart
If you’re not struggling with cancer pain, you probably shouldn’t be taking a prescription. methadone.
This is the message that emerges from startling statistics suggesting that inappropriate methadone use is linked to one-third of overdose deaths from prescription painkillers.
Methadone only accounted for 2% of prescriptions in 2009, according to Data from the Centers for Disease Control and Prevention that spanned 10 years and 13 states, but was responsible for 30% of deaths from prescription pain relievers.
“Methadone is riskier than other opiates for treating non-cancerous pain,” said Dr Thomas Frieden, director of the CDC, who added that there is limited scientific evidence that it works for chronic non-cancer pain. “It should only be used for pain when other medications have not worked.”
Frieden distinguished between methadone used to treat heroin addiction, for example, and the increased use of prescription methadone as the first resort to treat chronic pain.
It appears that some methadone-related deaths can be attributed to the 4 million prescriptions written for the drug each year in the United States. But according to the CDC report, “Studies using forensic data suggest … that most people who have overdosed use it without a prescription.”
And while there hasn’t been a dramatic increase in the number of prescriptions written for methadone over the years, the overdose rate from 1999 to 2009 has increased by about six-fold.
CDC data does not characterize how methadone overdose deaths occur, but prescription opioids are known to depress the functioning of the system central nervous system. Take too much methadone – or mix it with other CNS depressants like oxycodone, hydrocodone or even alcohol – could actually stop breathing.
“(Methadone) works differently in the bodies of different people,” Frieden said. “They take a small amount of it, but it could last for days in their body and cause serious problems.”
What can be confusing for patients taking the drug is that methadone has a long-acting effect – it tends to linger in the body. This means that once the pain relief wears off, the drug could still be circulating in someone’s system. Patients have problems when drugs with similar action are also introduced during this period.
But methadone can also be fatal on its own. According to the CDC’s weekly morbidity and mortality report this week, methadone was responsible for about 40% of deaths related to single-use opioids.
The risk of overdose is higher when methadone is prescribed for the first time, if the dose is increased, or if your doctor has recently switched you to methadone from another medicine, depending on consumer information on the drug published on the National Institutes of Health website.
Methadone may owe its preferred pain reliever status to the fact that it is cheaper than other prescription opiates, according to Frieden. But cheap does not equate to efficient.
“Using methadone for pain relief is insane and insane,” Frieden said.
“The societal costs of saving a dollar or two from a pill,” in terms of death, addiction and other problems, he added, “are just too high.”
Some solutions to the prescription opioid problem may lie in actions already taken by some states, including prescription drug monitoring programs.
And the responsibility lies with doctors as well, according to the CDC’s most recent report on vital signs.
“Providers should only use methadone as a pain reliever for conditions where the benefits outweigh the risks to patients and society,” according to the report. “Methadone and other extended-release opioids should not be used for mild pain, sharp pain,“ breakthrough ”pain, or as needed. “