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September 24, 09

NEWS / Multi-Stakeholder Initiative Reduces Methadone- Associated Deaths

Initiative Aims to Prevent Diversion and Decrease the Upward Trend of Methadone Deaths through a Voluntary Restriction of the 40-Milligram Formulation

SEP 24 - ARLINGTON, VA – Stakeholders at a Methadone-Associated Mortality and Overdose meeting hosted by the U. S. Drug Enforcement Administration (DEA) concluded that a January 2008 voluntary restriction of the 40 milligram methadone diskette had a positive impact on decreasing overdoses and deaths. The 2008 voluntary initiative, restricting the distribution of the 40 milligram methadone diskette to Narcotic Treatment Programs (NTP) and hospitals, was implemented in response to a rise in deaths associated with overdose and misuse of methadone. The stakeholders agreed to extend the initiative.

According to the Centers for Disease Control, from 1999 to 2005 (the latest year for which figures are available), the number of poisoning deaths mentioning methadone increased 468 percent, accounting for 14 percent, or one in seven, of all poisoning deaths in the United States. Medical examiners, federal agencies, pharmaceutical industry representatives, pain management practitioners and others at the meeting considered evidence suggesting a decrease in mortality and overdose incidents that was presented by state medical examiners and representatives of the pain and poison community, in addition to considering other recommendations to slow this upward trend.

“This voluntary initiative demonstrates our steadfast commitment to ensuring the safety and well being of those who use methadone for legitimate medical purposes,” said DEA Acting Administrator Michele M. Leonhart. “Bringing these stakeholders together on this issue will help increase the knowledge of this drug’s effects, and help reduce the number of overdoses and deaths due to methadone poisoning. This is an important step forward for medicine, treatment, and pain-management.”

“I talk to a lot of different groups – law enforcement groups, community groups, professional groups – throughout the country. And I talk a lot about prescription drug issues. Generally, they all have a prescription drug problem, but when I start talking about methadone, everybody sits up and takes notice, especially in the law enforcement community,” said Special Agent Joe Rannazzisi, DEA’s Deputy Assistant Administrator for the Office of Diversion Control. “Like many other prescription drugs, methadone is beneficial when used in the right way, but can be harmful and even lethal when used incorrectly.”

In recent years, methadone has become popular as a pain medication for the general population, partly because it’s less expensive than other narcotics, such as Oxycontin. Because of its long and unpredictable half-life, methadone stays in the bloodstream longer than many other pain medications. While methadone’s beneficial effects last 4 to 6 hours, it can take as long as 59 hours to dissipate. As a result, appropriate individual dosages are difficult to calculate.

Many people believe prescription drugs are safer than illicit street drugs because they are prescribed by doctors to treat illnesses and conditions like pain. But if used improperly or without supervision, prescription drugs can be addictive and lethal. Surveys commissioned by the U. S. Department of Health and Human Services, such as the National Survey on Drug Use and Health as well as the Monitoring the Future Survey, show that prescription drugs are now more frequently abused than heroin, and prescription drugs are used more often now by teenagers than all illicit drugs other than marijuana.

Although there has been a measure of success combating the rising deaths associated with methadone and other prescription drugs, overdose and deaths associated with prescription drug abuse remain a problem. Continued efforts are critical to stop this epidemic. Data presented at the meeting suggests that additional measures and awareness may further reduce overdose and mortality of prescription drugs. Other strategies considered by the stakeholders for reducing methadone-associated deaths included:

Raising public awareness about methadone’s dangers;
Increasing educational opportunities for users, prescribers, pharmacists and insurers;
More aggressively collecting accurate data on methadone-related overdoses and deaths; and
Encouraging insurers to adopt new practices for determining prescription benefits that will minimize prescription drug abuse.




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