Dangers of Methadone Usage

Implications: Doctors must be educated on the correct use of Methadone if unnecessary deaths are to be avoided.

Analysis:  Methadone, once used mainly in addiction treatment centers, is being prescribed by family doctors, osteopaths, and nurse practitioners for back pain, joint injuries, and other severe pain.  Because it is abused by some users and not prescribed correctly by health professionals because they are unfamiliar with its risks, Methadone is now the fastest growing cause of narcotic deaths.  Methadone is implicated in twice as many deaths as heroin.  Methadone creates dependency and is sometimes sought by abusers who claim they experience a special “buzz” when they use it with Xanax.  From 1990 to 2005, deaths that had Methadone listed as a contributor increased by nearly five fold to 4,462.  This number is probably understated.  Federal regulators acknowledge that they were slow to recognize the dangers of widespread Methadone use for other than addiction control. A dangerously high dosage (80 mg) recommendation remained in the FDA-approved package insert until late 2006.  The recommended dosage has now been lowered.   Oxycontin, another more expensive opiate, is still widely prescribed, but currently many health plans do not reimburse for this product.  They will, however, reimburse for Methadone because of its low cost.  Yet, for the right patient, Methadone, prescribed in the correct dosage, is effective in reducing pain.   In their  efforts to rectify Methadone misuse, some government officials and doctors want to go even further and require prescribers to take a course before recommending Methadone. However, many doctors and patients are wary of any governmental interventions that would slow down access to pain treatments.   The majority of patients who died using Methadone also used large quantities of alcohol or benzodiazepines.  Fewer would have died without an opioid as the primary culprit.