As I covered in a recent article, methadone-related deaths increased by 700% between 1999 and 2006, and the numbers are still rising. Yesterday’s New York Times article about methadone deaths definitely shed some light on what’s going on. Until a couple of years ago, the dose recommended by the FDA was 80 mg/day - enough to kill some people who are not used to taking opiates. And it’s killing some people very quickly – they don’t even have time to get addicted or get into a drug addiction treatment center.

Doctors not understanding how to prescribe the drug is another major factor. Of course, they followed the FDA’s recommendations.

The third factor is that patients sometimes take more than is prescribed because they don’t get the immediate relief they expect. But because the drug is already in the blood-stream, they overdose.

The fourth factor is the combination of drugs and alcohol. This is probably where drug addiction treatment should come into play. Doctor’s aren’t looking at the patient’s history to see if they can be relied upon to not take other central nervous system depressants – including alcohol. The doctor who prescribed the methadone to one person who died knew of this history and said he told the patient to stop drinking. Well, as anyone familiar with addiction knows, telling someone who’s taking drugs or drinking a lot to stop is simply not enough. They need the help of a drug addiction treatment center.

Bottom line - this is one area where doctors just don’t know what they’re doing. Nor do the patients. Nor does the FDA.  There might be studies out there somewhere that could have predicted something like this happening with methadone but, since drug companies that conducted the studies don’t exactly have a reputation for putting all the cards on the table, we don’t really know.

Drugs are a little like politics – if you don’t really do your research and understand the issues, you can wind up voting for someone who can wind up with some big, and unfortunate, surprises.

Do your research, look for drug-free solutions, and if you or someone you care about has a drug or alcohol problem, get them into a drug addiction treatment center. The prescription drug addiction epidemic is bad enough – we don’t need people getting killed by these drugs right off the bat.

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A methadone clinic opened up about two years ago in Indiana. The goal was to provide a closer location for those on methadone treatment – which is supposed to help heroin addicts through withdrawal so they can then get through drug rehab at a drug addiction treatment center so they’ll be drug free. 

I get tons of responses from readers of this blog whenever I write about methadone treatment. They tell me how it’s saved their lives and that it was a last resort.

According to a recent news article, the clinic in Indiana is using it as anything but a last resort. The requirements for getting methadone from this clinic are that the person has been addicted to an opiate for at least one year.  And many of the people they’re servicing are addicted to prescription drugs – it’s opiates, so it would be OxyContin or a similar painkiller – that they were given by their doctor and then couldn’t quit.

Wow. So much for methadone treatment being used as a last resort.

“They don’t want to lose their job or lose their kids,” said the program director. “They come to us because they want to be safe, and they want to be legal.”

So, now, instead of long-time heroin addicts being addicted to methadone, we have people addicted to methadone because they couldn’t quit taking OxyContin or some similar drug because of surgery or an illness.

The program director says they’re supposed to get daily methadone for a while but are supposed to start weaning off it within three to six months. He said it works for some, and not for others. Of course. That’s because they’re getting methadone instead of going to a drug addiction treatment center that can help them with their addiction.

Prescription drug addiction – especially OxyContin addiction or addiction to another painkiller – is like heroin addiction. Just like we’ve been saying. And, like heroin addiction, the solution is drug rehab. Not methadone.
 

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This week’s Prescription Drug Addiction Radio Show (on WGUL 860 AM on Sunday night, July 20 – 9:05 p.m. Eastern, live online at www.860wgul.com) will feature pharmacists talking about the problem of – guess what – prescription drug addiction. Here’s what Larry G, the show’s host, has to say about the problem:

“The drug companies call them pain pills and the drug addicts call them Oxys, Roxies and Blueberries. The doctors call them alprazolam and on the street they are called Ladders, Bars and Totem Poles, but horribly it is now estimated that deaths that include prescription drugs are surpassing deaths from guns in the United States.”

Drug rehab in Florida has especially got it’s hands full – Florida medical examiners reported 8,620 drug-related deaths in Florida in 2007, and about 69% of them involved prescription drugs. The drugs that were involved in the majority of deaths were methadone, benzodiazepines, oxycodone, hydrocodone, and morphine.

The saddest thing is that, unlike people who take street drugs, many of the people who overdose on and die from prescription drugs though the drugs were safe, and never saw it coming.

Larry G, a pharmacist for 30 years, is doing our society a great service with this radio show. Tune in, find out more about prescription drug addiction, and get anyone you think might need help into a drug addiction treatment center asap.  Also, check out Drug Rehab Referral for additional info on prescription drug addiction, street drugs, and drug addiction treatment.

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If anyone is considering going onto a methadone maintenance program as a solution to heroin addiction, you should have a look at this news article that describes one person’s experience trying to get off methadone. Getting off methadone cold turkey is anguish – I can tell you that from personal experience, I’ve gotten off both heroin and methadone. Methadone was worse. Your best bet is probably a good medical drug detox program to help through the withdrawal, and then drug rehab after that to get down to the bottom of the addiction problem and continue the rehabilitation of your body.

Sometimes getting off drugs, especially opiates, can be pretty hard on you emotionally.  Taking opiates by-passes the body’s natural endorphin production – the natural production process slows down because the drugs are supplying what’s needed.  When you stop taking the drugs, it can take a while for the body’s endorphin production to fully kick back in and get up to snuff.  As endorphins are natural mood elevators and painkillers, you can feel a little miserable for a while.

If you get into a longer-term residental drug rehab program – we’re talking about months, not weeks – and you’re getting the nutrition, exercise, and so on, that you need to get healthy, things should kick in just fine and, by the time you leave drug rehab, you’ll feel pretty good. Probably better than you have in a long time, actually.

However, some people get discouraged when things don’t change quickly enough. This is one of the reasons people think drug rehab doesn’t work. They expect things to change but don’t necessarily do all the things necessary for that change to occur, and they don’t do them long enough. So, they wind up back on the drug. Or on methadone replacement therapy.

If you or someone you care about is trying to get off opiates, bear the above in mind. Find a good long-term residential drug rehab program that understands all the elements that makes recovery possible and has them built into the program. And if you’re having a really hard time with withdrawal, consider doing a medical drug detox prior to the  drug rehab program. It doesn’t take long and you can get through withdrawal safely and with a minimum of discomfort. Then you’re properly set up to get through the longer process of full rehabilitation and recovery.

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Another methadone incident – a man charged with involuntary manslaughter after his 2-year-old son died after drinking methadone. The man left his kids alone in the bathroom with an open bottle of methadone. The story doesn’t say why the guy had the methadone, but if he was an addict – rather than someone who had methadone in the house temporarily as a pain reliever - let’s hope he now tries to get into drug rehab.

We gets lots of comments on our blogs about methadone. Many are from parents whose children died from it one way or another, and others are from former heroin addicts who have traded their addiction to heroin for an addiction to methadone. They have been told that their bodies don’t produce enough endorphins and that they therefore can’t really live any kind of normal life without opiates. That’s also the reason they’ve been told drug rehab didn’t work for them.

I’ve asked methadone users for specific information on the testing they had done to prove that their bodies were incapable of producing endorphins, but I’ve never been given any evidence that testing like that has even been done. It appears to be an assumption.

In any case, we now have another tragic incident of methadone-related death. A drug rehab program is still a safer solution.

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I really don’t care how many methadone supporters comment on this blog – have at it. Here’s the story of the eigth methadone-related death in the town of Laconia, New Hampshire – population 17,000. This is a 20-year-old boy who came home apparently somewhat inebriated, was told by his mother to sleep it off, and never woke up. His mom knew he had a problem but, obviously, she didn’t know it would kill him. She is not alone. I would bet that the majority of tragedies like that come as a complete suprise. Parents, take heed – get your kids into drug rehab if they have an alcohol or drug problem. You never know what the next day will bring.

Methadone-related deaths increased by six times from 1999 to 2006. Cocaine-related deaths rose by 63% in the same time period.

If you know someone with a drug problem, don’t take it lightly. It’s true that some drugs are more dangerous than others, but it’s also true that the judgement of a person on drugs is impaired. It’s also true that many people, even those very familiar with a variety of drugs, often don’t understand what the drug can do to them and how they will react.

You can’t be too careful. Get them into a drug rehab program now. 

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The most recent comments on the methadone blog included one from a woman who had migraines from her mid teens and has three fractured discs. She hurts – all the time. Personally, I would never expect someone in that condition to live without painkillers – in this case, it’s methadone. Living in severe chronic pain pretty much ruins your life.

I would also never suggest that someone who’s been through drug rehab or other treatment 17 times just “pull themselves up the bootstraps.”  

But I would be very interested to know if the person who said that people with an opiate addiction cannot be cured meant to imply that that goes for anyone with an opiate addiction.  Is that what you meant? Are you implying that all opiate addicts should go on methadone if they want to get off heroin or other opiates because there’s no hope for them to get off the drugs and stay off them? That they shouldn’t even bother attempting drug rehab because, as you said, recovery “will not happen”?

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People taking methadone will find drug detox or drug rehab is more expensive than methadone maintenance. It costs roughly $4,000 a year to keep someone on methadone – a drug detox may cost $5,000 to $10,000, and a drug rehab program may cost three  times that, and sometimes more.  So why bother going through any sort of drug detox or drug rehab program?

One reason is you are more likely to die when you are taking prescription drugs than if you aren’t. There were 58 methadone-related deaths in Connecticut in 2006 and about 4,000 nationwide. One doctor says that methadone use needs to be monitored very closely, something that is not likely in this day and age. Doctors as a group don’t spend the time with their patients to closely monitor what they are doing. There are several ways you could die from methadone, using it as prescribed, abusing it, and using or abusing it mixed with some other drug or alcohol. Xanax is one of the more common drugs people mix with methadone – a very dangerous combination.  Of course, methadone does not have to kill you, but the chances are it may kill one or two out of a hundred.
 
From a financial standpoint, getting off methadone makes more sense if you have a four-year time horizon and you look five years into the future. Then, there’s no question which is better.
 
Let’s say you have been taking methadone for pain but you are now dependent on it and have tried to stop but can’t – an inpatient drug detox could be your best bet. If you are on it for other, non-medical, reasons then a drug detox followed by a drug rehab is a good idea.

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