Methadone for pain relief can be permanent!

I am a little late with this update from our coroner's office - but I thought this an interesting read - ~~~

Tuesday, June 03, 2008
Methadone for pain relief can be permanent
I was reading an article entitled “The Methadone Poisoning Epidemic” in The Forensic Examiner magazine (sorry no link, it was paper) and I wanted to share a few points with you.

Using information from a National Center for Health Statistics report the author relates that in 2003 methadone-related deaths rose 29%, while drug related deaths as a whole only increased 6%. In addition, methadone was responsible for more deaths than any single prescription painkiller listed (that doesn’t reflect our experience while we see these sorts of methadone overdose deaths, those with hydrocodone and oxycodone are in higher numbers here). The number of unique patient prescriptions for methadone increased 80% through 2005 and 2006 (in most cases prescribed for pain management).

The real key and the point the author really stresses is that methadone overdoses occur by in large in folks using methadone as a pain medicine, not in folks on methadone as maintenance therapy for opiate addiction. This is primarily because while the drug half life in the body is 24 to 36 hours, the pain relief effect lasts 4-6 hours. While the intent is to reach steady state for pain modulation, folks start chasing their pain with additional doses. Those additional doses build over time because of the long “real” half life with lethal consequences.

This lethality is compounded by concomitant use of other medications and certain underlying medical conditions, like sleep apnea and prolonged QT interval heart conduction problems.

Methadone is a dangerous drug for pain management and many don’t realize that (patients and doctors alike). It should be used with caution and only with a physician very familiar with the drug and with highly motivated and conscientious patients.

Medication sharing can result in death

I grabbed this from Dr. Richard Keller, our Lake County Coroner ~
IMO - a need to know for passers by!

…roughly 23 percent reported loaning their prescription medications to someone else, and 27 percent reported borrowing prescription medications.

The medications most frequently shared (loaned or borrowed) were allergy drugs like Allegra (25 percent), followed by pain medications like Darvocet and OxyContin (22 percent); and antibiotics like amoxicillin (21 percent).

Seven percent of those interviewed said they shared mood-altering drugs like Paxil, Zoloft, Ritalin and Valium.
This certainly seems to agree with what we see in our cases of death due to licit drug intoxication or overdose, although certainly our death cases are more heavily weighted toward pain meds and “mood-alerting drugs”. This is a huge problem. People really don’t realize the danger in sharing, trading, and taking someone else’s meds. Just because they come from a drug store doesn’t mean they are always safe.