PAINKILLER LINKED TO RISE IN OVERDOSE DEATHS

Doctors prescribing methadone for pain relief may inadvertently be the
cause of an alarming rise in deaths related to the drug in the US.
Forensic science experts fear that a huge increase in methadone
prescriptions is feeding the black market and encouraging abuse.

In 2001, the Food and Drug Administration's MedWatch programme
recorded 61 methadone-related deaths in the US. That is more than
occurred in the whole of the 1990s, and by 2002 the number had doubled
to 123.

The figures confirm reports from Maine, Florida, Oklahoma, North
Carolina, West Virginia and Maryland that methadone-related deaths are
rising. Methadone is often used to wean addicts off heroin, and the
recent spate of deaths has led to calls for heroin-treatment
programmes to be curtailed.

But the drug is also used to treat chronic pain - in cancer patients,
for example. It works well because it stays in the body for a long
time, taking between 15 and 55 hours to be broken down to half its
initial levels, compared with a matter of minutes for heroin. The
downside is that this means accidental overdoses are common, even when
the drug is prescribed.

Black Market

According to a report in February by the Substance Abuse and Mental
Health Services Administration in Rockville, Maryland - the federal
agency that oversees methadone distribution for addiction treatment -
the amount of the drug dispensed by pharmacies has more than trebled
since 1998, while its use in addiction treatment has hardly changed.

This suggests that the rising death toll is mainly due to misuse of
methadone prescribed for pain relief. While 40 tablets cost as little
as $5 on Medicaid, each tablet can be worth $10 to $20 if sold on the
black market.

Reports from Oklahoma back this up. Ronald Distefano, from the state's
Office of the Chief Medical Examiner, told the American Academy of
Forensic Sciences annual conference in Dallas, Texas, in February that
in 2001 and 2002 around two-thirds of the people whose deaths were
associated with methadone did not have a prescription for the drug.

What's more, the SAMHSA report shows that while seizures of illegal
methadone pills more than doubled from 2001 to 2002, seizures of
liquid methadone only increased by 11 per cent.

The liquid form is the type most often prescribed for addicts. At
post-mortem, methadone is often found along with other drugs, which
makes it difficult to pin down the exact cause of death.

But Bruce Goldberger, a toxicologist and vice-president of the AAFS,
thinks that the figures mark a new trend in drug abuse. "I have never
seen this number of deaths before," he says. "It is a new generation
of people using drugs."