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CDC: Alarming Increase in Methadone Deaths

Deaths From Opioid Painkillers Have Tripled Since 1999
By
WebMD Health News
Reviewed by Louise Chang, MD

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Sept. 30, 2009 -- Methadone deaths have risen sevenfold in less than a decade, according to a government report that largely blames the increase on the growing use of methadone for pain relief.

Used primarily for the management of heroin addiction until the late 1990s, methadone has become one of the most widely prescribed opioid painkillers, with 4 million prescriptions written for pain relief in 2006 alone.

It has also become one of the most deadly drugs around, the report from the CDC’s National Center for Health Statistics (NCHS) confirms.

The report highlights the rising death rate associated with the use of opioid painkillers such as methadone, morphine, OxyContin, Dilaudid, and Vicodin.

Between 1999 and 2006, according to the report:

  • Deaths from the use of opioid pain relievers more than tripled in the U.S., from 4,000 in 1999 to 13,800 in 2006. 
  • 40% of all poisoning deaths in 2006 in the U.S. involved opioid painkillers. 
  • The number of poisoning deaths involving methadone increased from 790 to 5,420 during this period. 
  • The opioid death rate was highest for whites, males, and people between the ages of 35 and 54.

 

The Problem With Methadone

The increase in methadone deaths corresponds to the drug’s increased use for pain relief, which began abruptly in 1999, says Nicholas Reuter, a public health analyst who has been tracking methadone use and deaths for the Substance Abuse and Mental Health Services Administration.

Increased concerns about the abuse potential of the pain reliever OxyContin and the desire for a relatively inexpensive long-acting opioid painkiller led to the shift in methadone use.

Last year, 750,000 methadone prescriptions were written for pain relief, but only 250,000 people were treated with the drug for addiction to heroin and other opioids, Reuter tells WebMD.

Methadone can suppress drug withdrawal symptoms as an addiction treatment for 24 hours; the drug’s ability to suppress pain lasts just four to eight hours.

But methadone stays in the system as long as 59 hours. Patients may feel they need more pain relief before the drug is cleared from the body, and if taken too often or at doses that are too high, toxic levels can build up, which can lead to life-threatening changes in breathing and heart function.

”Many of the methadone deaths I hear about involve people who just go to sleep at night and never wake up,” Reuter says.

 

Deadly Mix: Methadone, Sedatives

In a report released last March examining methadone-related deaths, the Government Accountability Office concluded that a lack of knowledge about the “unique pharmacological properties” of the drug among prescribing physicians and patients has contributed to the problem, as has a rise in methadone’s use as an illegal street drug.

The newly released NCHS mortality figures were derived from death certificates, so there was no way to know if the drugs were legally prescribed or not.

But at least half of the reported opioid-related deaths involved other drugs, including heroin or cocaine in 15% of cases and benzodiazepines such as Xanax and Valium in 17% of cases.

“The involvement of benzodiazepines -- sedatives used to treat anxiety, insomnia, and seizures -- is particularly troubling as previous studies have shown that people who were prescribed both methadone and benzodiazepine were at greater risk of overdose than those prescribed only one of these drugs,” the report notes.

“We don’t know how the people who died got the drugs they took,” NCHS epidemiologist Margaret Warner, PhD, tells WebMD. “Federal agencies, including the Food and Drug Administration and the Drug Enforcement Administration, are looking at methadone to determine how much of the problem is due to the drug getting into the wrong hands.”

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