METHADONE DEATHS UP IN WESTERN VIRGINIA

ROANOKE, Va. (AP) - Four years after OxyContin abuse became widespread in
southwest Virginia, authorities are seeing an increase in fatal overdoses
from another prescription painkiller - methadone. Forty-four people died
from methadone overdoses last year in the western half of Virginia, said
Dr. William Massello, assistant chief medical examiner in Roanoke. There
were 40 fatal overdoses from oxycodone, the active ingredient in OxyContin,
during the same period.

The numbers are the latest evidence of a prescription drug abuse problem
that is most prevalent in the southwest region of the state.

Authorities are not sure what to make of the methadone deaths, which have
been climbing for several years while OxyContin abuse has been the topic of
widespread attention from law enforcement, politicians and the news media.

"We're theorizing that perhaps because of the bad publicity that OxyContin
has received, there are physicians who are switching to methadone" to treat
pain, Massello said. The pharmaceutical black market is driven primarily by
"doctor shoppers" who fake ailments to obtain drugs from multiple
physicians and then sell them on the street.

Another theory is that prescription drug abusers are being forced to turn
to other drugs such as methadone because increased law enforcement efforts
have made it harder for them to find OxyContin on the street.

"I still think OxyContin is the drug of choice," said Tazewell County
Commonwealth's Attorney Dennis Lee, who serves on a state task force
studying prescription drug abuse. "But in a pinch, people will buy
methadone and use it also."

Methadone is a synthetic narcotic that is perhaps best known as a treatment
for people addicted to opium-based drugs such as heroin, morphine and
OxyContin. Operating under tight security, methadone clinics provide a
liquid form of the drug that blocks withdrawal symptoms, making it easier
for addicts to get clean.

But methadone is also prescribed in tablets to treat pain. It is that form
of the drug that seems most susceptible to abuse.

Roanoke pain specialist Cecil Knox is facing charges of illegally
prescribing both OxyContin and methadone. A wrongful death lawsuit also
claims that Knox overprescribed methadone to a patient who suffered a fatal
overdose.

Massello said he was aware of only one or two cases in which a methadone
overdose victim had been receiving treatment at a clinic.

He said fewer than half of the methadone overdose victims examined by his
office had a valid prescription for the drug, suggesting that many of them
got their methadone from what he called a "thriving black market."

There have been 21 fatal methadone overdoses so far this year in western
Virginia. Oxycodone deaths number 10. Because it takes up to two months for
autopsy toxicology tests to be completed, the latest figures cover only the
first quarter of the year.

Like OxyContin, methadone is abused by addicts who crush the tablets and
then snort or inject the powder.

But methadone does not produce the same rush as OxyContin, according to
Holly Catania of the Baron Edmond deRothschild Chemical Dependency
Institute of the Beth Israel Medical Center in New York.

"Methadone is typically not a recreational drug," Catania said. People who
abuse the drug are most likely to be heroin or OxyContin users who "are
trying to get a break" by taking an opium-based drug that will ease their
cravings without making them high, she said.