DRUG CLINIC DEATHS PROBED

State Looks into Methadone Cases

CHARLOTTE - State health officials are investigating the deaths in
the past year of at least 16 patients treated for drug addiction at
clinics run by a Charlotte company.

The probe comes as the state tries to combat a growing number of
deaths involving methadone, a drug traditionally used to help heroin
addicts but increasingly prescribed as a painkiller.

In 2004, North Carolina's 245 methadone-poisoning deaths trailed only
Florida's, according to a new federal study.

The N.C. Department of Health and Human Services is investigating 13
patients' deaths this year and three late last year involving McLeod
Addictive Disease Center. Health officials list the probable cause of
death as methadone toxicity or a lethal combination of methadone and
other drugs.

Few comparative data exist on methadone deaths involving clinics;
state and federal authorities couldn't say for certain whether
McLeod's 16 deaths are unusually high.

"I can only say that would be troubling to us here," said Robert
Lubran, head of the federal agency that regulates methadone clinics.
He said state officials have asked for help in responding to the
deaths at the company's clinics.

McLeod President Eugene Hall said his company runs an exemplary
program that follows all state and federal guidelines. McLeod
operates eight clinics throughout the Charlotte region and in Marion
and Boone. It bills itself as the Carolinas' largest methadone
treatment program.

Mcleod Denies Blame

Hall said his clinics serve more than 6,000 people each year, an
increase of about 2,000 in the past three years. By his company's
count, 19 patients died this year in methadone-related cases -- the
same number as in each of the two previous years. (McLeod defines
methadone-related deaths more broadly than the state; thus the higher number.)

"I've welcomed [state officials] down to look at our program," he
said. "If we're not doing it right, then nobody's doing it right."

State rules require clinics to report all deaths to county-based
regulators, and state officials are supposed to track such statistics.

But methadone clinics, like group homes and other state-regulated
facilities, operate largely on an honor system when it comes to
reporting deaths.

When asked last week how many clinic patients have died statewide,
state officials said they did not have the data readily available.

Methadone has traditionally been used to wean addicts from heroin and
other drugs. Increasingly, doctors have prescribed it for chronic
pain, or for patients who have become addicted to powerful
painkillers such as OxyContin.

Prescriptions Rise

Methadone prescriptions nationwide jumped from about half a million
in 1998 to more than 4 million last year, federal statistics show.
Most of the new users are patients with prescriptions for pain medication.

Experts say methadone is so powerful that improper dosages, or
combining it with other drugs such as cocaine, Valium or Xanax, can
prove fatal.

In North Carolina, methadone-related deaths of all types jumped from
121 in 2001 to 318 in 2005, state figures show. South Carolina had 37
deaths in 2004, according to a federal study.

Government and academic researchers say clinics aren't to blame for
much of the increase. Instead, they point to the growing use of the
drug as a prescription painkiller. The amount of methadone sold to
state pharmacies and hospitals quadrupled between 1997 and 2001, one
study showed.

Patients who take the drug at home, rather than in the controlled
doses offered at clinics, are more likely to misuse it, said Lubran,
with the U.S. Department of Health and Human Services.

Federal officials in recent months have been warning all states to
keep an eye out for increases in methadone deaths.

State health officials say such federal advisories prompted them to
investigate McLeod, a nonprofit company with nearly 300 employees.