Monday, May 21, 2007

Dying For Attention

Obviously, addicts warrant treatment. However, this is disturbing. Methadone overdoses accounting for forty-one percent? The aforesaid must be reversed. Kentucky could assume the forefront. We could pioneer new therapies. However, we have Governor Fletcher. These facts scream investigation. Minamally, they crave sympathy. However, Ernie Fletcher notices only votes.

From the Lexington Herald-Leader:

Methadone is the top cause of deadly overdoses reviewed by the state, prompting health officials to warn of the drug's dangers and to encourage medical workers to look out for abuse symptoms, according to information released Monday by the Office of Drug Control Policy.

The prescription drug was detected in 41 percent of the 484 overdose deaths in Kentucky in 2006, the latest statistics available, according to a written statement from the drug police office. The statistics are cited in the state medical examiner's annual report, which noted 197 deaths attributed to methadone in cases autopsied by the state medical examiner's office. Methadone overdose deaths are increasing. In 2005, the drug was detected in 39 percent of overdose deaths reviewed by the state medical examiner’s office. The total number of cases – 484 – was the same as in 2006.

"Prescription drug overdoses in general, and methadone overdoses in particular, claim a large number of lives each year in the commonwealth. These tragic deaths of Kentuckians are unnecessary and preventable," Dr. Tracey Corey, the chief medical examiner, said in the written news release. "Regional and local medical societies and health departments may help reduce this tragic loss of life by making patients and physicians aware of the possibility of accidental fatal overdose associated with the use of prescription narcotics, especially when used in concert with other prescription drugs."

The deaths are occurring even though the number of methadone prescriptions or typical doses did not greatly change from 2003 to 2006. Nationally, methadone-related deaths climbed from about 780 in 1999 to more than 3,800 in 2004, according to a national study cited by Kentucky authorities.

Drug policy office executive director Laurie Dudgeon warned about the misuse of methadone and urged emergency workers and hospital workers to educate themselves on the symptoms and effects of methadone misuse. The office plans to hold seminars to educate the public and health-care workers. "The seriousness of methadone overdose and its possible consequences cannot be overemphasized," Dudgeon said in the written statement.

Methadone is used to treat pain and addiction to narcotics or opiates.

1 comment:

Mark Beresky said...

I agree that these tragic deaths could have been avoided. We are not told in this report how many deaths were due to drugs obtained by prescription or by purchasing the drug on the street.
I suspect both methods of procural are involved but I’m also aware that there are many medical professionals who are not adequately knowledgeable in the safe and proper use of methadone. Some have only recently become aware of the average doctor’s ability to prescribe methadone for the treatment of pain having believed that the drug was only used for the treatment of chronic opiate addiction in clinics licensed by the federal government.
Methadone is an essential tool in the treatment of chronic pain and chronic opioid addiction. It is a wonder drug for people suffering from chronic intractable pain and has improved the lives of many thousands of Americans. Methadone is also the most effective treatment for chronic opioid addiction for a large percentage of those unfortunates who require such treatment.
But, methadone is a drug to be careful with. To clarify Mr. Stalleng’s statement in a release by the Ky. Justice and Public Safety Cabinet that methadone “has a shorter duration in the body than other controlled pain relievers…” let me add that methadone has an effective duration of action in pain control of 4-8 hours but has a plasma elimination duration of 8-59 hours; compared to morphine which has a plasma elimination of 1-5 hours. Part of the first dose might still be present when a patient begins day three taking this medication. But, pain control and plasma duration are variable due to individual metabolism. Understanding this is essential to calculate proper dosage.
Methadone is a long acting drug. To my knowledge it stays in the body longer than any other pain reliever with the exception of sustained-release pain relievers. It is also a long acting respiratory depressant and can cause problems for patients who experience heart irregularities like “long QT syndrome” and “Torsades de Pointe”. Patients with sleep apnea should be carefully considered before prescribing methadone because of its respiratory depressant qualities.
To put it simply: Methadone is a valuable resource for those who require it but the prescription of this drug must be performed by medical professionals who are fully aware of its long half-life and contraindications for a variety of patients and for a variety of reasons.
Education is the key. For medical professionals and the public alike.
Mark Beresky
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